Adverse Childhood Events and Alcohol Consumption

Author

Bryana A. S. Thieret

Abstract

Those with a history of Adverse Childhood Events (ACE) are shown to have increased risk for alcohol dependency and lifetime use, but this has only been viewed through the number of ACEs experienced (i.e., as a count). The current research investigates how the type of adversity impacts 4 different measures of alcohol consumption using the The Behavioral Risk Factor Surveillance System survey. Results indicate that the type of adversity has a large impact on alcohol consumption behavior compared to the number of ACEs experienced. There was also evidence that certain groupings of advertises increased or decreased risk for alcohol consumption compared to others with the same number of adversities reported. Further research should focus on indicating type of adversity with risk rather than number of adversies experienced.

Introduction

Adverse childhood events (ACE) are adversities that occur from birth to 18 years old and are often categorized into 8 major categories consisting of emotional abuse, physical abuse, sexual abuse, neglect, domestic violence in the household, substance use in the household, incarcerated household member, parental separation or divorce (Merrick et al., 2018). They are categorized/standardized in this way to be able to collect data on prevalence of ACEs in a population. There is a plethora of evidence that shows ACEs and early-life adversity (ELA) increases risk for addiction and addiction-like behavior (Felitti et al., 2019; Shin et al., 2018; Strine et al., 2012; Loudermilk et al., 2018; Pilowsky et al., 2009; Dube et al., 2003; Sharma & Sacco, 2015; Kim et al., 2018; Gomez et al., 2018; Guarino et al., 2021; Stein et al., 2017).

Previous research shows that the greater the number of ACEs a person a person experiences, the greater the risk becomes for maladaptive and impulsive long-term behavior. The problem with categorizing by number is it ignores the potential for different types of adversity to have different long-term risks. The present research explores the impact of the type of adversity and alcohol consumption through 4 questions asked in The Behavioral Risk Factor Surveillance System (BRFSS) survey.

Methods

In 1984, the Center for Disease Control and Prevention (CDC) started a yearly survey called The Behavioral Risk Factor Surveillance System (BRFSS) which collects general health and behavioral practices to better understand the needs of those in the United States. It is one of the largest health surveys in the world and helps epidemiologists and those in public health identify increased risk regarding general health, quality of life, and trends in behavior.

In 2009 the BRFSS started to collect data on ACEs, but since this survey is delegated by state, there are many that either do not collect this information yearly or asks about only a few ACEs (for further information see table here). The current analysis consists of data from 2019 to 2023 because ACE questions before 2019 are severely reduced in the different ACE categories asked about.

Adverse Childhood Events

The BRFSS asks ACE questions pertaining to mental illness in the household, alcohol misuse in the household, substance addiction in the household, incarcerated household member, parental separation or divorce, domestic violence in the household, physical abuse, emotional abuse, sexual abuse, and neglect. The questions asked that pertain to each ACE and the abbreviations used throughout this paper are shown in Table 1.

Table 1
Adverse Childhood Event Questions and Categorization

ACE Category Abbreviations SAS Variable Name Question Asked
Mental illness in the household MentalIllness, MI ACEDEPRES Did you live with anyone who was depressed, mentally ill, or suicidal?
Alcohol misuse in the household Alcohol, A ACEDRINK Did you live with anyone who was a problem drinker or alcoholic?
Substance addiction in the household SubstanceAddiction, SubAddic ACEDRUGS Did you live with anyone who used illegal street drugs or who abused prescription medications?
Incarcerated household member Incarcerated, I ACEPRISN Did you live with anyone who served time or was sentenced to serve time in a prison, jail, or other correctional facility?
Parental separation or divorce SeparationDivorce, S/D ACEDIVRC Were your parents separated or divorced?
Domestic violence in the household DomesticViolence, DV ACEPUNCH How often did your parents or adults in your home ever slap, hit, kick, punch or beat each other up?
Physical abuse PhysicalAbuse, PA ACEHURT1 Not including spanking, (before age 18), how often did a parent or adult in your home ever hit, beat, kick, or physically hurt you in any way?
Emotional abuse EmotionalAbuse, EA ACESWEAR How often did a parent or adult in your home ever swear at you, insult you, or put you down?
Sexual abuse SexualAbuse1, SA1 ACETOUCH How often did anyone at least 5 years older than you or an adult, ever touch you sexually?
Sexual abuse SexualAbuse2, SA2 ACETHEM How often did anyone at least 5 years older than you or an adult, try to make you touch them sexually?
Sexual abuse SexualAbuse3, SA3 ACEHVSEX How often did anyone at least 5 years older than you or an adult, force you to have sex?
Neglect Neglect1, N1 ACEADSAF For how much of your childhood was there an adult in your household who made you feel safe and protected? Would you say never, a little of the time, some of the time, most of the time, or all of the time?
Neglect Neglect2, N2 ACEADNED For how much of your childhood was there an adult in your household who tried hard to make sure your basic needs were met? Would you say never, a little of the time, some of the time, most of the time, or all of the time?

Measures for Impulsivity

To narrow our focus we will investigate the connection between ACEs and different measures for alcohol consumption. This survey consists of specifically 4 questions pertaining to alcohol consumption which is shown in Table 2 along with the question asked in the survey. The dependent measure for the four measures evaluating alcohol consumption use a numeric value/count whether that be the number of days or the number of alcoholic drinks consumed.

Table 2
Questions Measuring Alcohol Consumption

Measure SAS Variable Name Question Asked
Alcohol consumption in days per week ALCDAY5/ALCDAY4 During the past 30 days, how many days per week did you have at least one drink of any alcoholic bevarage?
Alcohol consumption in days per month ALCDAY5/ALCDAY4 During the past 30 days, how many days per month did you have at least one drink of any alcoholic beverage such as beer, wine, a malt beverage or liquor?
Times in the past 30 days where 4 or more drinks were consumed DRNK3GE5 Considering all types of alcoholic beverages, how many times during the past 30 days did you have 5 or more drinks for men or 4 or more drinks for women on an occasion?
Greatest number of drinks consumed on any occassion in the past 30 days MAXDRNKS During the past 30 days, what is the largest number of drinks you had on any occasion?

Data Analysis

The dependent measures being counts lends well to using a poisson regression in further analyses over linear regression. The important things to keep in mind when using a poisson regression is overdispersion which occurs when the variability in the data set is greater than the mean squared (\(\lambda^2\)) resulting in underestimated standard errors making estimates overly significant. In order to avoid this we will be modeling through quasipoisson regressions which will adjust the standard errors if there is overdispersion present. The \(\alpha\) level used will be 1.00% (0.01) which is more strict compared to typical 5.00% \(\alpha\) levels but is used because the current analysis is interested in clear differences between groups through the use null-hypothesis testing. Estimates are reported as relative risk where the original \(\beta\) estimate was expatiated.

All final models presented were compared between 6 different models using a chi-square test which uses null and residual deviance along with the degrees of freedom to compare which one has a significantly” better fit over the others. The models ranged from no interactions throughout the model to three-way interactions between all variable. Please refer to “ReportQ1.qmd” for the model comparisons made in the results section referred to as “Alcohol consumption in days per week”, “ReportQ2.R” for the model comparisons made in the results section referred to as “Alcohol comsumption in days per month”, “ReportQ3.R” for the model comparisons made in the results section referred to as “Occasions of binge drinking in the past month”, and “ReportQ4.R” for the model comparisons made in the results section referred to as “Maximum number of drinks on any occasion in the past month”.

Results

Alcohol consumption in days per week

The first question refers to the number of days per week the respondent reports drinking an alcoholic beverage. This question has been coded in a way that allows the respondent to report if they do not drink alcohol generally speaking which was excluded in this analysis to evaluate if the consumption of alcohol per week differs between those who report a history of early-life adversity compared to those who have not.

The first equation we see below is the final model used to predict the number of drinks consumed per week while the second equation includes the \(\beta\) estimates which are rounded to 2 decimal places.

\[\begin{equation} \begin{split} ln(\lambda) =& \\ &\beta_0 + \\ &\beta_1 (\text{Male}) + \\ &\beta_2 (\text{25 to 34}) + \beta_3 (\text{35 to 44}) + \beta_4 (\text{45 to 54}) + \beta_5 (\text{55 to 64}) + \beta_6 (\text{65 or > 65}) + \\ &\beta_7 (\text{MentalIllness}) + \beta_8 (\text{MentalIllness} \cdot \text{25 to 34}) + \beta_9 (\text{MentalIllness} \cdot \text{35 to 44}) + \beta_{10} (\text{MentalIllness} \cdot \text{45 to 54}) + \\ &\qquad \beta_{11} (\text{MentalIllness} \cdot \text{55 to 64}) + \beta_{12} (\text{MentalIllness} \cdot \text{65 or > 65}) + \beta_{13} (\text{MentalIllness} \cdot \text{Male}) + \\ &\beta_{14} (\text{Alcohol}) + \beta_{15} (\text{Alcohol} \cdot \text{25 to 34}) + \beta_{16} (\text{Alcohol} \cdot \text{35 to 44}) + \beta_{17} (\text{Alcohol} \cdot \text{45 to 54}) + \\ &\qquad \beta_{18} (\text{Alcohol} \cdot \text{55 to 64}) + \beta_{19} (\text{Alcohol} \cdot \text{65 or > 65}) + \beta_{20} (\text{Alcohol} \cdot \text{Male}) + \\ &\beta_{21} (\text{SubstanceAddiction}) + \beta_{22} (\text{SubstanceAddiction} \cdot \text{25 to 34}) + \beta_{23} (\text{SubstanceAddiction} \cdot \text{35 to 44}) + \\ &\qquad \beta_{24} (\text{SubstanceAddiction} \cdot \text{45 to 54}) + \beta_{25} (\text{SubstanceAddiction} \cdot \text{55 to 64}) + \\ &\qquad \beta_{26} (\text{SubstanceAddiction} \cdot \text{65 or > 65}) + \beta_{27} (\text{SubstanceAddiction} \cdot \text{Male}) + \\ &\beta_{28} (\text{Incarcerated}) + \beta_{29} (\text{Incarcerated} \cdot \text{25 to 34}) + \beta_{30} (\text{Incarcerated} \cdot \text{35 to 44}) + \beta_{31} (\text{Incarcerated} \cdot \text{45 to 54}) + \\ &\qquad \beta_{32} (\text{Incarcerated} \cdot \text{55 to 64}) + \beta_{32} (\text{Incarcerated} \cdot \text{65 or > 65}) + \beta_{33} (\text{Incarcerated} \cdot \text{Male}) + \\ &\beta_{34} (\text{SeparationDivorce}) + \beta_{35} (\text{SeparationDivorce} \cdot \text{25 to 34}) + \beta_{36} (\text{SeparationDivorce} \cdot \text{35 to 44}) + \\ &\qquad \beta_{37} (\text{SeparationDivorce} \cdot \text{45 to 54}) + \beta_{38} (\text{SeparationDivorce} \cdot \text{55 to 64}) + \\ &\qquad \beta_{39} (\text{SeparationDivorce} \cdot \text{65 or > 65}) + \beta_{40} (\text{SeparationDivorce} \cdot \text{Male}) + \\ &\beta_{41} (\text{DomesticViolence}) + \beta_{42} (\text{DomesticViolence} \cdot \text{25 to 34}) + \beta_{43} (\text{DomesticViolence} \cdot \text{35 to 44}) + \\ &\qquad \beta_{44} (\text{DomesticViolence} \cdot \text{45 to 54}) + \beta_{45} (\text{DomesticViolence} \cdot \text{55 to 64}) + \\ &\qquad \beta_{46} (\text{DomesticViolence} \cdot \text{65 or > 65}) + \beta_{47} (\text{DomesticViolence} \cdot \text{Male}) + \\ &\beta_{48} (\text{PhysicalAbuse}) + \beta_{49} (\text{PhysicalAbuse} \cdot \text{25 to 34}) + \beta_{50} (\text{PhysicalAbuse} \cdot \text{35 to 44}) + \\ &\qquad \beta_{51} (\text{PhysicalAbuse} \cdot \text{45 to 54}) + \beta_{52} (\text{PhysicalAbuse} \cdot \text{55 to 64}) + \\ &\qquad \beta_{53} (\text{PhysicalAbuse} \cdot \text{65 or > 65}) + \beta_{54} (\text{PhysicalAbuse} \cdot \text{Male}) + \\ &\beta_{55} (\text{EmotionalAbuse}) + \beta_{56} (\text{EmotionalAbuse} \cdot \text{25 to 34}) + \beta_{57} (\text{EmotionalAbuse} \cdot \text{35 to 44}) + \\ &\qquad \beta_{58} (\text{EmotionalAbuse} \cdot \text{45 to 54}) + \beta_{59} (\text{EmotionalAbuse} \cdot \text{55 to 64}) + \\ &\qquad \beta_{60} (\text{EmotionalAbuse} \cdot \text{65 or > 65}) + \beta_{61} (\text{EmotionalAbuse} \cdot \text{Male}) + \\ &\beta_{62} (\text{SexualAbuse1}) + \beta_{63} (\text{SexualAbuse1} \cdot \text{25 to 34}) + \beta_{64} (\text{SexualAbuse1} \cdot \text{35 to 44}) + \\ &\qquad \beta_{65} (\text{SexualAbuse1} \cdot \text{45 to 54}) + \beta_{66} (\text{SexualAbuse1} \cdot \text{55 to 64}) + \\ &\qquad \beta_{67} (\text{SexualAbuse1} \cdot \text{65 or > 65}) + \beta_{68} (\text{SexualAbuse1} \cdot \text{Male}) + \\ &\beta_{69} (\text{SexualAbuse2}) + \beta_{70} (\text{SexualAbuse2} \cdot \text{25 to 34}) + \beta_{71} (\text{SexualAbuse2} \cdot \text{35 to 44}) + \\ &\qquad \beta_{72} (\text{SexualAbuse2} \cdot \text{45 to 54}) + \beta_{73} (\text{SexualAbuse2} \cdot \text{55 to 64}) + \\ &\qquad \beta_{74} (\text{SexualAbuse2} \cdot \text{65 or > 65}) + \beta_{75} (\text{SexualAbuse2} \cdot \text{Male}) + \\ &\beta_{76} (\text{SexualAbuse3}) + \beta_{77} (\text{SexualAbuse3} \cdot \text{25 to 34}) + \beta_{78} (\text{SexualAbuse3} \cdot \text{35 to 44}) + \\ &\qquad \beta_{79} (\text{SexualAbuse3} \cdot \text{45 to 54}) + \beta_{80} (\text{SexualAbuse3} \cdot \text{55 to 64}) + \\ &\qquad \beta_{81} (\text{SexualAbuse3} \cdot \text{65 or > 65}) + \beta_{82} (\text{SexualAbuse3} \cdot \text{Male}) + \\ &\beta_{83} (\text{Neglect1}) + \beta_{84} (\text{Neglect1} \cdot \text{25 to 34}) + \beta_{85} (\text{Neglect1} \cdot \text{35 to 44}) + \beta_{86} (\text{Neglect1} \cdot \text{45 to 54}) + \\ &\qquad \beta_{87} (\text{Neglect1} \cdot \text{55 to 64}) + \beta_{88} (\text{Neglect1} \cdot \text{65 or > 65}) + \beta_{89} (\text{Neglect1} \cdot \text{Male}) + \\ &\beta_{90} (\text{Neglect2}) + \beta_{91} (\text{Neglect2} \cdot \text{25 to 34}) + \beta_{92} (\text{Neglect2} \cdot \text{35 to 44}) + \beta_{93} (\text{Neglect2} \cdot \text{45 to 54}) + \\ &\qquad \beta_{94} (\text{Neglect2} \cdot \text{55 to 64}) + \beta_{95} (\text{Neglect2} \cdot \text{65 or > 65}) + \beta_{96} (\text{Neglect2} \cdot \text{Male}) + \\ \end{split} \end{equation} \] \[\begin{align*} ln(\lambda) =& \\ &2.84 + \\ &1.00 (\text{Male}) + \\ &1.01 (\text{25 to 34}) + 0.70 (\text{35 to 44}) + 0.88 (\text{45 to 54}) + 0.97 (\text{55 to 64}) + 1.19 (\text{65 or > 65}) + \\ &0.90 (\text{MentalIllness}) + 1.27 (\text{MentalIllness} \cdot \text{25 to 34}) + 1.11 (\text{MentalIllness} \cdot \text{35 to 44}) + 1.17 (\text{MentalIllness} \cdot \text{45 to 54}) + \\ &\qquad 1.17 (\text{MentalIllness} \cdot \text{55 to 64}) + 1.14 (\text{MentalIllness} \cdot \text{65 or > 65}) + 1.00 (\text{MentalIllness} \cdot \text{Male}) + \\ &1.01 (\text{Alcohol}) + 1.04 (\text{Alcohol} \cdot \text{25 to 34}) + 1.00 (\text{Alcohol} \cdot \text{35 to 44}) + 1.05 (\text{Alcohol} \cdot \text{45 to 54}) + \\ &\qquad 1.05 (\text{Alcohol} \cdot \text{55 to 64}) + 1.01 (\text{Alcohol} \cdot \text{65 or > 65}) + 1.02 (\text{Alcohol} \cdot \text{Male}) + \\ &1.04 (\text{SubstanceAddiction}) + 0.97 (\text{SubstanceAddiction} \cdot \text{25 to 34}) + 1.02 (\text{SubstanceAddiction} \cdot \text{35 to 44}) + \\ &\qquad 1.03 (\text{SubstanceAddiction} \cdot \text{45 to 54}) + 0.98 (\text{SubstanceAddiction} \cdot \text{55 to 64}) + \\ &\qquad 0.91 (\text{SubstanceAddiction} \cdot \text{65 or > 65}) + 1.02 (\text{SubstanceAddiction} \cdot \text{Male}) + \\ &1.06 (\text{Incarcerated}) + 0.95 (\text{Incarcerated} \cdot \text{25 to 34}) + 0.95 (\text{Incarcerated} \cdot \text{35 to 44}) + 0.95 (\text{Incarcerated} \cdot \text{45 to 54}) + \\ &\qquad 0.84 (\text{Incarcerated} \cdot \text{55 to 64}) + 0.98 (\text{Incarcerated} \cdot \text{65 or > 65}) + 1.02 (\text{Incarcerated} \cdot \text{Male}) + \\ &1.00 (\text{SeparationDivorce}) + 0.99 (\text{SeparationDivorce} \cdot \text{25 to 34}) + 0.97 (\text{SeparationDivorce} \cdot \text{35 to 44}) + \\ &\qquad 1.06 (\text{SeparationDivorce} \cdot \text{45 to 54}) + 0.98 (\text{SeparationDivorce} \cdot \text{55 to 64}) + \\ &\qquad 1.02 (\text{SeparationDivorce} \cdot \text{65 or > 65}) + 1.02 (\text{SeparationDivorce} \cdot \text{Male}) + \\ &0.93 (\text{DomesticViolence}) + 1.00 (\text{DomesticViolence} \cdot \text{25 to 34}) + 1.04 (\text{DomesticViolence} \cdot \text{35 to 44}) + \\ &\qquad 1.08 (\text{DomesticViolence} \cdot \text{45 to 54}) + 1.11 (\text{DomesticViolence} \cdot \text{55 to 64}) + \\ &\qquad 1.06 (\text{DomesticViolence} \cdot \text{65 or > 65}) + 0.95 (\text{DomesticViolence} \cdot \text{Male}) + \\ &1.02 (\text{PhysicalAbuse}) + 0.95 (\text{PhysicalAbuse} \cdot \text{25 to 34}) + 1.00 (\text{PhysicalAbuse} \cdot \text{35 to 44}) + \\ &\qquad 0.99 (\text{PhysicalAbuse} \cdot \text{45 to 54}) + 0.99 (\text{PhysicalAbuse} \cdot \text{55 to 64}) + \\ &\qquad 0.95 (\text{PhysicalAbuse} \cdot \text{65 or > 65}) + 1.03 (\text{PhysicalAbuse} \cdot \text{Male}) + \\ &1.06 (\text{EmotionalAbuse}) + 0.91 (\text{EmotionalAbuse} \cdot \text{25 to 34}) + 0.95 (\text{EmotionalAbuse} \cdot \text{35 to 44}) + \\ &\qquad 0.91 (\text{EmotionalAbuse} \cdot \text{45 to 54}) + 0.95 (\text{EmotionalAbuse} \cdot \text{55 to 64}) + \\ &\qquad 0.95 (\text{EmotionalAbuse} \cdot \text{65 or > 65}) + 1.00 (\text{EmotionalAbuse} \cdot \text{Male}) + \\ &1.06 (\text{SexualAbuse1}) + 0.86 (\text{SexualAbuse1} \cdot \text{25 to 34}) + 1.07 (\text{SexualAbuse1} \cdot \text{35 to 44}) + \\ &\qquad 1.04 (\text{SexualAbuse1} \cdot \text{45 to 54}) + 0.95 (\text{SexualAbuse1} \cdot \text{55 to 64}) + \\ &\qquad 0.98 (\text{SexualAbuse1} \cdot \text{65 or > 65}) + 1.04 (\text{SexualAbuse1} \cdot \text{Male}) + \\ &1.08 (\text{SexualAbuse2}) + 1.11 (\text{SexualAbuse2} \cdot \text{25 to 34}) + 1.02 (\text{SexualAbuse2} \cdot \text{35 to 44}) + \\ &\qquad 0.89 (\text{SexualAbuse2} \cdot \text{45 to 54}) + 1.00 (\text{SexualAbuse2} \cdot \text{55 to 64}) + \\ &\qquad 0.90 (\text{SexualAbuse2} \cdot \text{65 or > 65}) + 0.92 (\text{SexualAbuse2} \cdot \text{Male}) + \\ &1.04 (\text{SexualAbuse3}) + 0.81 (\text{SexualAbuse3} \cdot \text{25 to 34}) + 1.00 (\text{SexualAbuse3} \cdot \text{35 to 44}) + \\ &\qquad 1.07 (\text{SexualAbuse3} \cdot \text{45 to 54}) + 0.90 (\text{SexualAbuse3} \cdot \text{55 to 64}) + \\ &\qquad 0.97 (\text{SexualAbuse3} \cdot \text{65 or > 65}) + 0.99 (\text{SexualAbuse3} \cdot \text{Male}) + \\ &0.95 (\text{Neglect1}) + 0.63 (\text{Neglect1} \cdot \text{25 to 34}) + 1.14 (\text{Neglect1} \cdot \text{35 to 44}) + 1.06 (\text{Neglect1} \cdot \text{45 to 54}) + \\ &\qquad 0.99 (\text{Neglect1} \cdot \text{55 to 64}) + 0.89 (\text{Neglect1} \cdot \text{65 or > 65}) + 1.12 (\text{Neglect1} \cdot \text{Male}) + \\ &0.73 (\text{Neglect2}) + 1.80 (\text{Neglect2} \cdot \text{25 to 34}) + 1.54 (\text{Neglect2} \cdot \text{35 to 44}) + 1.33 (\text{Neglect2} \cdot \text{45 to 54}) + \\ &\qquad 1.40 (\text{Neglect2} \cdot \text{55 to 64}) + 1.44 (\text{Neglect2} \cdot \text{65 or > 65}) + 1.02 (\text{Neglect2} \cdot \text{Male}) + \\ \end{align*}\]

Interpretation

Those who are female, between the ages of 18-24, and report no history of an ACE drink on average 2.84 days out of the 7 days a week (\(\beta_0 = 2.84\), \(SE = 0.26\), \(t = 4.03\), \(p < .0001\)). Those who are males do not on average report any different from the average number of days where alcohol is consumed compared to females, between the ages of 18-24, that report no history of an ACE (\(\beta_1 = 1.00\), \(SE = 0.13\), \(t = -0.01\), \(p = 0.989\)). Those who were between the ages of 25 to 34 (\(\beta_2 = 1.01\), \(SE = 0.30\), \(t = 0.04\), \(p = .967\)), 35 to 44 (\(\beta_3 = 0.70\), \(SE = 0.30\), \(t = -1.18\), \(p = 0.238\)), 45 to 54 (\(\beta_4 = 0.88\), \(SE = 0.28\), \(t = -0.46\), \(p = .646\)), 55 to 64 (\(\beta_5 = 0.97\), \(SE = 0.29\), \(t = -0.12\), \(p = 0.906\)), or 65 and older (\(\beta_6 = 1.19\), \(SE = 0.27\), \(t = 0.65\), \(p = 0.514\)) did not show any increased risk for the number of days on average to consume alcohol out of the week compared to females between the ages of 18-24 that report no history of any ACE.

Those that report to experience mental illness in the household, alcohol misuse in the household, substance addiction in the household, incarcerated household member, parental separation or divorce, domestic violence in the household, physical abuse, emotional abuse, sexual abuse, and/or neglect show to not increase or decrease relative risk for the number of days on average to consume alcohol per week (see Table 1). Interactions between ACEs that also report being a male do not show any differences in relative risk for average days to consume alcohol per week compared to females between the ages of 18-24 that report no history of an ACE (see Table 3).

Those that report a history of mental illness in the household that are also between the ages of 25 to 34 show on average a 1.27 times greater number of days per week compared to females between the ages of 18-24 that report no history of an ACE (\(\beta_8 = 1.27\), \(SE = 0.09\), \(t = 2.63\), \(p = .0084\)). In addition, those who generally report a history of mental illness in the household and/or are a part of any other age category do not report any differently from the average number of days that those that are females between the ages of 18-24 that report no history of an ACE consume alcohol per week (see Table 3 for further information).

All other interactions between ACEs and age category show no difference in relative risk for average days to consume alcohol per week compared to females between the ages of 18-24 that report no history of an ACE (see Table 3 for further information).

Table 3
Estimates for ACE Terms and Interactions

Table
term estimate std.error statistic p.value
MentalIllness1 0.90 0.08 -1.29 0.1979417
MentalIllness1:sexMale 1.00 0.03 0.03 0.9748654
MentalIllness1:age25 to 34 1.27 0.09 2.63 0.0084309
MentalIllness1:age35 to 44 1.11 0.09 1.15 0.2517294
MentalIllness1:age45 to 54 1.17 0.09 1.80 0.0716143
MentalIllness1:age55 to 64 1.17 0.09 1.77 0.0768719
MentalIllness1:age65 or > 65 1.14 0.08 1.53 0.1252644
Alcoholic1 1.01 0.09 0.14 0.8850159
sexMale:Alcoholic1 1.02 0.03 0.71 0.4801076
age25 to 34:Alcoholic1 1.04 0.10 0.42 0.6781284
age35 to 44:Alcoholic1 1.00 0.10 0.00 0.9987382
age45 to 54:Alcoholic1 1.05 0.09 0.52 0.6047333
age55 to 64:Alcoholic1 1.05 0.09 0.58 0.5603437
age65 or > 65:Alcoholic1 1.01 0.09 0.16 0.8745557
SubstanceAddiction1 1.04 0.10 0.36 0.7194477
sexMale:SubstanceAddiction1 1.02 0.05 0.34 0.7331666
age25 to 34:SubstanceAddiction1 0.97 0.12 -0.24 0.8099443
age35 to 44:SubstanceAddiction1 1.02 0.12 0.13 0.8955182
age45 to 54:SubstanceAddiction1 1.03 0.11 0.24 0.8065069
age55 to 64:SubstanceAddiction1 0.98 0.11 -0.16 0.8697752
age65 or > 65:SubstanceAddiction1 0.91 0.11 -0.84 0.4036290
Incarcerated1 1.06 0.10 0.55 0.5828030
sexMale:Incarcerated1 1.02 0.06 0.33 0.7423656
age25 to 34:Incarcerated1 0.95 0.12 -0.40 0.6858854
age35 to 44:Incarcerated1 0.95 0.12 -0.46 0.6477703
age45 to 54:Incarcerated1 0.95 0.12 -0.47 0.6416775
age55 to 64:Incarcerated1 0.84 0.12 -1.42 0.1551753
age65 or > 65:Incarcerated1 0.98 0.12 -0.19 0.8514482
SeparationDivorce1 1.00 0.07 -0.06 0.9541464
sexMale:SeparationDivorce1 1.02 0.03 0.50 0.6143466
age25 to 34:SeparationDivorce1 0.99 0.08 -0.18 0.8547409
age35 to 44:SeparationDivorce1 0.97 0.08 -0.37 0.7081886
age45 to 54:SeparationDivorce1 1.06 0.08 0.73 0.4631794
age55 to 64:SeparationDivorce1 0.98 0.08 -0.29 0.7725610
age65 or > 65:SeparationDivorce1 1.02 0.07 0.30 0.7654413
DomesticViolence1 0.93 0.10 -0.72 0.4699014
sexMale:DomesticViolence1 0.95 0.04 -1.26 0.2083755
age25 to 34:DomesticViolence1 1.00 0.11 -0.01 0.9935557
age35 to 44:DomesticViolence1 1.04 0.11 0.37 0.7122748
age45 to 54:DomesticViolence1 1.08 0.11 0.71 0.4784484
age55 to 64:DomesticViolence1 1.11 0.10 0.99 0.3220177
age65 or > 65:DomesticViolence1 1.06 0.10 0.60 0.5474126
PhysicalAbuse1 1.02 0.09 0.24 0.8093570
sexMale:PhysicalAbuse1 1.03 0.03 1.08 0.2803566
age25 to 34:PhysicalAbuse1 0.95 0.10 -0.53 0.5982619
age35 to 44:PhysicalAbuse1 1.00 0.10 0.00 0.9976175
age45 to 54:PhysicalAbuse1 0.99 0.10 -0.08 0.9371102
age55 to 64:PhysicalAbuse1 0.99 0.09 -0.12 0.9031826
age65 or > 65:PhysicalAbuse1 0.95 0.09 -0.54 0.5898040
EmotionalAbuse1 1.06 0.07 0.74 0.4582622
sexMale:EmotionalAbuse1 1.00 0.03 -0.03 0.9795443
age25 to 34:EmotionalAbuse1 0.91 0.08 -1.15 0.2511190
age35 to 44:EmotionalAbuse1 0.95 0.08 -0.58 0.5591706
age45 to 54:EmotionalAbuse1 0.91 0.08 -1.14 0.2542469
age55 to 64:EmotionalAbuse1 0.95 0.08 -0.69 0.4883272
age65 or > 65:EmotionalAbuse1 0.95 0.08 -0.71 0.4794852
SexualAbuse11 1.06 0.15 0.38 0.7009469
sexMale:SexualAbuse11 1.04 0.06 0.75 0.4526843
age25 to 34:SexualAbuse11 0.86 0.18 -0.85 0.3972516
age35 to 44:SexualAbuse11 1.07 0.17 0.41 0.6796264
age45 to 54:SexualAbuse11 1.04 0.16 0.25 0.8040949
age55 to 64:SexualAbuse11 0.95 0.16 -0.29 0.7701966
age65 or > 65:SexualAbuse11 0.98 0.15 -0.14 0.8911107
SexualAbuse21 1.08 0.17 0.44 0.6571834
sexMale:SexualAbuse21 0.92 0.07 -1.24 0.2156358
age25 to 34:SexualAbuse21 1.11 0.20 0.55 0.5843555
age35 to 44:SexualAbuse21 1.02 0.19 0.10 0.9209394
age45 to 54:SexualAbuse21 0.89 0.19 -0.61 0.5395544
age55 to 64:SexualAbuse21 1.00 0.18 0.01 0.9883133
age65 or > 65:SexualAbuse21 0.90 0.18 -0.59 0.5566763
SexualAbuse31 1.04 0.15 0.28 0.7797217
sexMale:SexualAbuse31 0.99 0.08 -0.16 0.8725282
age25 to 34:SexualAbuse31 0.81 0.19 -1.10 0.2732559
age35 to 44:SexualAbuse31 1.00 0.18 0.02 0.9866685
age45 to 54:SexualAbuse31 1.07 0.17 0.37 0.7148241
age55 to 64:SexualAbuse31 0.90 0.17 -0.59 0.5567586
age65 or > 65:SexualAbuse31 0.97 0.17 -0.19 0.8526844
Neglect11 0.95 0.22 -0.22 0.8281434
sexMale:Neglect11 1.12 0.09 1.31 0.1895296
age25 to 34:Neglect11 0.63 0.28 -1.70 0.0892193
age35 to 44:Neglect11 1.14 0.24 0.55 0.5857203
age45 to 54:Neglect11 1.06 0.24 0.23 0.8166843
age55 to 64:Neglect11 0.99 0.24 -0.05 0.9617420
age65 or > 65:Neglect11 0.89 0.22 -0.52 0.6038610
Neglect21 0.73 0.30 -1.05 0.2922940
sexMale:Neglect21 1.02 0.14 0.11 0.9163733
age25 to 34:Neglect21 1.80 0.35 1.68 0.0937556
age35 to 44:Neglect21 1.54 0.34 1.27 0.2039455
age45 to 54:Neglect21 1.33 0.32 0.89 0.3730770
age55 to 64:Neglect21 1.40 0.32 1.05 0.2924620
age65 or > 65:Neglect21 1.44 0.30 1.22 0.2214335

 
 
 

Discussion

When we evaluate how a history of mental illness in the household impacts average alcoholic drinks per week, shown in Figure 1, the first thing that should be noted is that the number of ACE does not appear to effect the average number of alcoholic drinks per week. We also see that age category between those that report the same number and history of ACEs has the potential to be a factor that impacts the number of days that alcohol is consumed per week.

Figures 2, 3, 4, 5, and 6 show that there are generally difference between the history of ACE(s) and average amount of alcohol consumed per week, but there is also a lot of variability within age groups for those that report the same history of adversity.

 
 
 
Figure 1
History of Mental Illness and Average Alcoholic Drinks Per Week

Note. SA2 = sexual abuse 2 (i.e., forced to sexually touch abuser). A = alcohol misuse in household. SubAddic = substance addiction in the household. PA = physical abuse. SA1 = sexual abuse 1 (i.e., molestation). None = respondent did not report any ACE. S/D = parental separation or divorce. MI = mental illness in the household. EA = emotional abuse. I = incarcerated household member. SA3 = sexual abuse 3 (i.e., rape). N1 = neglect 1 (i.e., no adult in household who made them feel safe and protected). N2 = neglect 2 (i.e., no adult in household who tried hard to make sure their basic needs were met). DV = domestic violence in the household.

Figure 2
History of 1 Adverse Childhood Event and Average Days Where Alcohol is Consumed Per Week

Note. SA2 = sexual abuse 2 (i.e., forced to sexually touch abuser). A = alcohol misuse in household. SubAddic = substance addiction in the household. PA = physical abuse. SA1 = sexual abuse 1 (i.e., molestation). None = respondent did not report any ACE. S/D = parental separation or divorce. MI = mental illness in the household. EA = emotional abuse. I = incarcerated household member. SA3 = sexual abuse 3 (i.e., rape). N1 = neglect 1 (i.e., no adult in household who made them feel safe and protected). N2 = neglect 2 (i.e., no adult in household who tried hard to make sure their basic needs were met). DV = domestic violence in the household.

Figure 3
History of 2 Adverse Childhood Events and Average Days Where Alcohol is Consumed Per Week

Note. SA2 = sexual abuse 2 (i.e., forced to sexually touch abuser). A = alcohol misuse in household. SubAddic = substance addiction in the household. PA = physical abuse. SA1 = sexual abuse 1 (i.e., molestation). None = respondent did not report any ACE. S/D = parental separation or divorce. MI = mental illness in the household. EA = emotional abuse. I = incarcerated household member. SA3 = sexual abuse 3 (i.e., rape). N1 = neglect 1 (i.e., no adult in household who made them feel safe and protected). N2 = neglect 2 (i.e., no adult in household who tried hard to make sure their basic needs were met). DV = domestic violence in the household.

Figure 4
History of 3 Adverse Childhood Events and Average Days Where Alcohol is Consumed Per Week

Note. SA2 = sexual abuse 2 (i.e., forced to sexually touch abuser). A = alcohol misuse in household. SubAddic = substance addiction in the household. PA = physical abuse. SA1 = sexual abuse 1 (i.e., molestation). None = respondent did not report any ACE. S/D = parental separation or divorce. MI = mental illness in the household. EA = emotional abuse. I = incarcerated household member. SA3 = sexual abuse 3 (i.e., rape). N1 = neglect 1 (i.e., no adult in household who made them feel safe and protected). N2 = neglect 2 (i.e., no adult in household who tried hard to make sure their basic needs were met). DV = domestic violence in the household.

Figure 5
History of 4 Adverse Childhood Events and Average Days Where Alcohol is Consumed Per Week

Note. SA2 = sexual abuse 2 (i.e., forced to sexually touch abuser). A = alcohol misuse in household. SubAddic = substance addiction in the household. PA = physical abuse. SA1 = sexual abuse 1 (i.e., molestation). None = respondent did not report any ACE. S/D = parental separation or divorce. MI = mental illness in the household. EA = emotional abuse. I = incarcerated household member. SA3 = sexual abuse 3 (i.e., rape). N1 = neglect 1 (i.e., no adult in household who made them feel safe and protected). N2 = neglect 2 (i.e., no adult in household who tried hard to make sure their basic needs were met). DV = domestic violence in the household.

Figure 6
History of 5 or More Adverse Childhood Events and Average Days Where Alcohol is Consumed Per Week

Note. SA2 = sexual abuse 2 (i.e., forced to sexually touch abuser). A = alcohol misuse in household. SubAddic = substance addiction in the household. PA = physical abuse. SA1 = sexual abuse 1 (i.e., molestation). None = respondent did not report any ACE. S/D = parental separation or divorce. MI = mental illness in the household. EA = emotional abuse. I = incarcerated household member. SA3 = sexual abuse 3 (i.e., rape). N1 = neglect 1 (i.e., no adult in household who made them feel safe and protected). N2 = neglect 2 (i.e., no adult in household who tried hard to make sure their basic needs were met). DV = domestic violence in the household.

Alcohol consumption in days per month

The second question refers to the number of days per month the respondent consumes at least one alcoholic drink. This question has been coded in a way that allows the respondent to report if they do not drink alcohol at all which was excluded in this analysis to evaluate if the consumption of alcohol per week differs between those who report a history of early-life stress compared to those who have not.

Like in the first question, the first equation seen below is the final model used to predict the average number of drinks consumed per month while the second equation includes the \(\beta\) estimates which are all rounded to 2 decimal places.

\[\begin{equation} \begin{split} ln(\lambda) =& \\ &\beta_0 + \\ &\beta_1 (\text{Male}) + \\ &\beta_2 (\text{25 to 34}) + \beta_3 (\text{35 to 44}) + \beta_4 (\text{45 to 54}) + \beta_5 (\text{55 to 64}) + \beta_6 (\text{65 or > 65}) + \\ &\beta_7 (\text{MentalIllness}) + \beta_8 (\text{MentalIllness} \cdot \text{25 to 34}) + \beta_9 (\text{MentalIllness} \cdot \text{35 to 44}) + \beta_{10} (\text{MentalIllness} \cdot \text{45 to 54}) + \\ &\qquad \beta_{11} (\text{MentalIllness} \cdot \text{55 to 64}) + \beta_{12} (\text{MentalIllness} \cdot \text{65 or > 65}) + \beta_{13} (\text{MentalIllness} \cdot \text{Male}) + \\ &\beta_{14} (\text{Alcohol}) + \beta_{15} (\text{Alcohol} \cdot \text{25 to 34}) + \beta_{16} (\text{Alcohol} \cdot \text{35 to 44}) + \beta_{17} (\text{Alcohol} \cdot \text{45 to 54}) + \\ &\qquad \beta_{18} (\text{Alcohol} \cdot \text{55 to 64}) + \beta_{19} (\text{Alcohol} \cdot \text{65 or > 65}) + \beta_{20} (\text{Alcohol} \cdot \text{Male}) + \\ &\beta_{21} (\text{SubstanceAddiction}) + \beta_{22} (\text{SubstanceAddiction} \cdot \text{25 to 34}) + \beta_{23} (\text{SubstanceAddiction} \cdot \text{35 to 44}) + \\ &\qquad \beta_{24} (\text{SubstanceAddiction} \cdot \text{45 to 54}) + \beta_{25} (\text{SubstanceAddiction} \cdot \text{55 to 64}) + \\ &\qquad \beta_{26} (\text{SubstanceAddiction} \cdot \text{65 or > 65}) + \beta_{27} (\text{SubstanceAddiction} \cdot \text{Male}) + \\ &\beta_{28} (\text{Incarcerated}) + \beta_{29} (\text{Incarcerated} \cdot \text{25 to 34}) + \beta_{30} (\text{Incarcerated} \cdot \text{35 to 44}) + \beta_{31} (\text{Incarcerated} \cdot \text{45 to 54}) + \\ &\qquad \beta_{32} (\text{Incarcerated} \cdot \text{55 to 64}) + \beta_{32} (\text{Incarcerated} \cdot \text{65 or > 65}) + \beta_{33} (\text{Incarcerated} \cdot \text{Male}) + \\ &\beta_{34} (\text{SeparationDivorce}) + \beta_{35} (\text{SeparationDivorce} \cdot \text{25 to 34}) + \beta_{36} (\text{SeparationDivorce} \cdot \text{35 to 44}) + \\ &\qquad \beta_{37} (\text{SeparationDivorce} \cdot \text{45 to 54}) + \beta_{38} (\text{SeparationDivorce} \cdot \text{55 to 64}) + \\ &\qquad \beta_{39} (\text{SeparationDivorce} \cdot \text{65 or > 65}) + \beta_{40} (\text{SeparationDivorce} \cdot \text{Male}) + \\ &\beta_{41} (\text{DomesticViolence}) + \beta_{42} (\text{DomesticViolence} \cdot \text{25 to 34}) + \beta_{43} (\text{DomesticViolence} \cdot \text{35 to 44}) + \\ &\qquad \beta_{44} (\text{DomesticViolence} \cdot \text{45 to 54}) + \beta_{45} (\text{DomesticViolence} \cdot \text{55 to 64}) + \\ &\qquad \beta_{46} (\text{DomesticViolence} \cdot \text{65 or > 65}) + \beta_{47} (\text{DomesticViolence} \cdot \text{Male}) + \\ &\beta_{48} (\text{PhysicalAbuse}) + \beta_{49} (\text{PhysicalAbuse} \cdot \text{25 to 34}) + \beta_{50} (\text{PhysicalAbuse} \cdot \text{35 to 44}) + \\ &\qquad \beta_{51} (\text{PhysicalAbuse} \cdot \text{45 to 54}) + \beta_{52} (\text{PhysicalAbuse} \cdot \text{55 to 64}) + \\ &\qquad \beta_{53} (\text{PhysicalAbuse} \cdot \text{65 or > 65}) + \beta_{54} (\text{PhysicalAbuse} \cdot \text{Male}) + \\ &\beta_{55} (\text{EmotionalAbuse}) + \beta_{56} (\text{EmotionalAbuse} \cdot \text{25 to 34}) + \beta_{57} (\text{EmotionalAbuse} \cdot \text{35 to 44}) + \\ &\qquad \beta_{58} (\text{EmotionalAbuse} \cdot \text{45 to 54}) + \beta_{59} (\text{EmotionalAbuse} \cdot \text{55 to 64}) + \\ &\qquad \beta_{60} (\text{EmotionalAbuse} \cdot \text{65 or > 65}) + \beta_{61} (\text{EmotionalAbuse} \cdot \text{Male}) + \\ &\beta_{62} (\text{SexualAbuse1}) + \beta_{63} (\text{SexualAbuse1} \cdot \text{25 to 34}) + \beta_{64} (\text{SexualAbuse1} \cdot \text{35 to 44}) + \\ &\qquad \beta_{65} (\text{SexualAbuse1} \cdot \text{45 to 54}) + \beta_{66} (\text{SexualAbuse1} \cdot \text{55 to 64}) + \\ &\qquad \beta_{67} (\text{SexualAbuse1} \cdot \text{65 or > 65}) + \beta_{68} (\text{SexualAbuse1} \cdot \text{Male}) + \\ &\beta_{69} (\text{SexualAbuse2}) + \beta_{70} (\text{SexualAbuse2} \cdot \text{25 to 34}) + \beta_{71} (\text{SexualAbuse2} \cdot \text{35 to 44}) + \\ &\qquad \beta_{72} (\text{SexualAbuse2} \cdot \text{45 to 54}) + \beta_{73} (\text{SexualAbuse2} \cdot \text{55 to 64}) + \\ &\qquad \beta_{74} (\text{SexualAbuse2} \cdot \text{65 or > 65}) + \beta_{75} (\text{SexualAbuse2} \cdot \text{Male}) + \\ &\beta_{76} (\text{SexualAbuse3}) + \beta_{77} (\text{SexualAbuse3} \cdot \text{25 to 34}) + \beta_{78} (\text{SexualAbuse3} \cdot \text{35 to 44}) + \\ &\qquad \beta_{79} (\text{SexualAbuse3} \cdot \text{45 to 54}) + \beta_{80} (\text{SexualAbuse3} \cdot \text{55 to 64}) + \\ &\qquad \beta_{81} (\text{SexualAbuse3} \cdot \text{65 or > 65}) + \beta_{82} (\text{SexualAbuse3} \cdot \text{Male}) + \\ &\beta_{83} (\text{Neglect1}) + \beta_{84} (\text{Neglect1} \cdot \text{25 to 34}) + \beta_{85} (\text{Neglect1} \cdot \text{35 to 44}) + \beta_{86} (\text{Neglect1} \cdot \text{45 to 54}) + \\ &\qquad \beta_{87} (\text{Neglect1} \cdot \text{55 to 64}) + \beta_{88} (\text{Neglect1} \cdot \text{65 or > 65}) + \beta_{89} (\text{Neglect1} \cdot \text{Male}) + \\ &\beta_{90} (\text{Neglect2}) + \beta_{91} (\text{Neglect2} \cdot \text{25 to 34}) + \beta_{92} (\text{Neglect2} \cdot \text{35 to 44}) + \beta_{93} (\text{Neglect2} \cdot \text{45 to 54}) + \\ &\qquad \beta_{94} (\text{Neglect2} \cdot \text{55 to 64}) + \beta_{95} (\text{Neglect2} \cdot \text{65 or > 65}) + \beta_{96} (\text{Neglect2} \cdot \text{Male}) + \\ \end{split} \end{equation}\] \[\begin{align*} ln(\lambda) =& \\ &5.74 + \\ &1.25 (\text{Male}) + \\ &0.98 (\text{25 to 34}) + 0.66 (\text{35 to 44}) + 1.11 (\text{45 to 54}) + 1.43 (\text{55 to 64}) + 1.52 (\text{65 or > 65}) + \\ &1.02 (\text{MentalIllness}) + 1.06 (\text{MentalIllness} \cdot \text{25 to 34}) + 1.08 (\text{MentalIllness} \cdot \text{35 to 44}) + 1.07 (\text{MentalIllness} \cdot \text{45 to 54}) + \\ &\qquad 1.03 (\text{MentalIllness} \cdot \text{55 to 64}) + 1.06 (\text{MentalIllness} \cdot \text{65 or > 65}) + 0.95 (\text{MentalIllness} \cdot \text{Male}) + \\ &1.01 (\text{Alcohol}) + 0.93 (\text{Alcohol} \cdot \text{25 to 34}) + 0.89 (\text{Alcohol} \cdot \text{35 to 44}) + 0.98 (\text{Alcohol} \cdot \text{45 to 54}) + \\ &\qquad 0.90 (\text{Alcohol} \cdot \text{55 to 64}) + 0.91 (\text{Alcohol} \cdot \text{65 or > 65}) + 1.01 (\text{Alcohol} \cdot \text{Male}) + \\ &1.04 (\text{SubstanceAddiction}) + 0.89 (\text{SubstanceAddiction} \cdot \text{25 to 34}) + 0.96 (\text{SubstanceAddiction} \cdot \text{35 to 44}) + \\ &\qquad 0.87 (\text{SubstanceAddiction} \cdot \text{45 to 54}) + 1.04 (\text{SubstanceAddiction} \cdot \text{55 to 64}) + \\ &\qquad 0.95 (\text{SubstanceAddiction} \cdot \text{65 or > 65}) + 1.05 (\text{SubstanceAddiction} \cdot \text{Male}) + \\ &1.06 (\text{Incarcerated}) + 1.03 (\text{Incarcerated} \cdot \text{25 to 34}) + 0.98 (\text{Incarcerated} \cdot \text{35 to 44}) + 1.01 (\text{Incarcerated} \cdot \text{45 to 54}) + \\ &\qquad 0.88 (\text{Incarcerated} \cdot \text{55 to 64}) + 1.01 (\text{Incarcerated} \cdot \text{65 or > 65}) + 1.00 (\text{Incarcerated} \cdot \text{Male}) + \\ &1.01 (\text{SeparationDivorce}) + 0.97 (\text{SeparationDivorce} \cdot \text{25 to 34}) + 1.08 (\text{SeparationDivorce} \cdot \text{35 to 44}) + \\ &\qquad 1.03 (\text{SeparationDivorce} \cdot \text{45 to 54}) + 1.07 (\text{SeparationDivorce} \cdot \text{55 to 64}) + \\ &\qquad 1.05 (\text{SeparationDivorce} \cdot \text{65 or > 65}) + 1.02 (\text{SeparationDivorce} \cdot \text{Male}) + \\ &0.93 (\text{DomesticViolence}) + 1.05 (\text{DomesticViolence} \cdot \text{25 to 34}) + 0.99 (\text{DomesticViolence} \cdot \text{35 to 44}) + \\ &\qquad 1.02 (\text{DomesticViolence} \cdot \text{45 to 54}) + 1.07 (\text{DomesticViolence} \cdot \text{55 to 64}) + \\ &\qquad 1.02 (\text{DomesticViolence} \cdot \text{65 or > 65}) + 1.07 (\text{DomesticViolence} \cdot \text{Male}) + \\ &1.02 (\text{PhysicalAbuse}) + 1.03 (\text{PhysicalAbuse} \cdot \text{25 to 34}) + 0.94 (\text{PhysicalAbuse} \cdot \text{35 to 44}) + \\ &\qquad 1.03 (\text{PhysicalAbuse} \cdot \text{45 to 54}) + 1.10 (\text{PhysicalAbuse} \cdot \text{55 to 64}) + \\ &\qquad 1.00 (\text{PhysicalAbuse} \cdot \text{65 or > 65}) + 0.98 (\text{PhysicalAbuse} \cdot \text{Male}) + \\ &1.06 (\text{EmotionalAbuse}) + 0.94 (\text{EmotionalAbuse} \cdot \text{25 to 34}) + 1.05 (\text{EmotionalAbuse} \cdot \text{35 to 44}) + \\ &\qquad 0.98 (\text{EmotionalAbuse} \cdot \text{45 to 54}) + 0.95 (\text{EmotionalAbuse} \cdot \text{55 to 64}) + \\ &\qquad 0.97 (\text{EmotionalAbuse} \cdot \text{65 or > 65}) + 1.02 (\text{EmotionalAbuse} \cdot \text{Male}) + \\ &1.06 (\text{SexualAbuse1}) + 0.77 (\text{SexualAbuse1} \cdot \text{25 to 34}) + 0.94 (\text{SexualAbuse1} \cdot \text{35 to 44}) + \\ &\qquad 0.96 (\text{SexualAbuse1} \cdot \text{45 to 54}) + 0.91 (\text{SexualAbuse1} \cdot \text{55 to 64}) + \\ &\qquad 0.92 (\text{SexualAbuse1} \cdot \text{65 or > 65}) + 1.04 (\text{SexualAbuse1} \cdot \text{Male}) + \\ &1.08 (\text{SexualAbuse2}) + 1.52 (\text{SexualAbuse2} \cdot \text{25 to 34}) + 1.18 (\text{SexualAbuse2} \cdot \text{35 to 44}) + \\ &\qquad 1.23 (\text{SexualAbuse2} \cdot \text{45 to 54}) + 1.18 (\text{SexualAbuse2} \cdot \text{55 to 64}) + \\ &\qquad 1.20 (\text{SexualAbuse2} \cdot \text{65 or > 65}) + 1.02 (\text{SexualAbuse2} \cdot \text{Male}) + \\ &1.04 (\text{SexualAbuse3}) + 0.64 (\text{SexualAbuse3} \cdot \text{25 to 34}) + 0.78 (\text{SexualAbuse3} \cdot \text{35 to 44}) + \\ &\qquad 0.60 (\text{SexualAbuse3} \cdot \text{45 to 54}) + 0.68 (\text{SexualAbuse3} \cdot \text{55 to 64}) + \\ &\qquad 0.65 (\text{SexualAbuse3} \cdot \text{65 or > 65}) + 1.11 (\text{SexualAbuse3} \cdot \text{Male}) + \\ &0.95 (\text{Neglect1}) + 0.81 (\text{Neglect1} \cdot \text{25 to 34}) + 0.85 (\text{Neglect1} \cdot \text{35 to 44}) + 0.86 (\text{Neglect1} \cdot \text{45 to 54}) + \\ &\qquad 1.04 (\text{Neglect1} \cdot \text{55 to 64}) + 0.82 (\text{Neglect1} \cdot \text{65 or > 65}) + 0.88 (\text{Neglect1} \cdot \text{Male}) + \\ &0.73 (\text{Neglect2}) + 1.63 (\text{Neglect2} \cdot \text{25 to 34}) + 2.36 (\text{Neglect2} \cdot \text{35 to 44}) + 1.46 (\text{Neglect2} \cdot \text{45 to 54}) + \\ &\qquad 1.05 (\text{Neglect2} \cdot \text{55 to 64}) + 1.51 (\text{Neglect2} \cdot \text{65 or > 65}) + 1.30 (\text{Neglect2} \cdot \text{Male}) + \\ \end{align*}\]

Interpretation

Those who are female, between the ages of 18-24, and report no history of an ACE report on average drink an alcoholic beverage 5.74 days out of a month (\(\beta_0 = 5.74\), \(SE = 0.35\), \(t = 5.06\), \(p < .00001\)). Those who are male on average do not report any increased or decreased risk for the number of days to consume an alcoholic beverage out of a month compared to females between the ages of 18-24 and report no history of an ACE (\(\beta_1 = 1.25\), \(SE = 0.16\), \(t = 1.42\), \(p = .155\)). Those who are between the ages of 25 to 34 (\(\beta_2 = 0.98\), \(SE = 0.37\), \(t = -0.05\), \(p = .957\)), 35 to 44 (\(\beta_3 = 0.66\), \(SE = 0.40\), \(t = -1.05\), \(p = 0.292\)), 45 to 54 (\(\beta_4 = 1.11\), \(SE = 0.37\), \(t = 0.29\), \(p = .769\)), 55 to 64 (\(\beta_5 = 1.43\), \(SE = 0.35\), \(t = 1.01\), \(p = 0.315\)), or 65 and older (\(\beta_6 = 1.52\), \(SE = 0.34\), \(t = 1.24\), \(p = 0.215\)) do not show any increased risk for the number of days on average to consume alcohol out of the month compared to females between the ages of 18-24 that report no history of an ACE.

Those that reported a history of rape that were also between the ages of 45 to 54 (\(\beta_{78} = 0.60\), \(SE = 0.17\), \(t = -2.95\), \(p = .003\)), or 65 and older (\(\beta_{80} = 0.65\), \(SE = 0.16\), \(t = -2.66\), \(p = .008\)), respectively, were shown to have an on average 0.60 or 0.65 times lower risk for the number of days per month alcohol was consumed per month compared to females between the ages of 18-24 and not history of any ACE. Those that also report the same history of adversity but are between the ages of 25 to 34 or 55 to 64 were not shown to report on average a different number of days per month alcohol is consumed compared to females between the ages of 18-24 and no history of any ACE (see Table 4 for further information).

There were no two-way interactions between males and any of the 13 ACEs that indicated increased or decreased risk for the average number of days per month alcohol was consumed compared to females between the ages of 18-24 and no history of any ACE (see Table 4 for further information). In addition, all other interactions between ACEs and age category were shown not to differ in relative risk for average days to consume alcohol per month compared to females between the ages of 18-24 that report no history of an ACE (see Table 2).

Table 4
Estimates for ACE Terms and Interactions
Table
term estimate std.error statistic p.value
MentalIllness1 1.02 0.07 0.25 0.7997453
MentalIllness1:sexMale 0.95 0.03 -1.52 0.1279668
MentalIllness1:age25 to 34 1.06 0.08 0.76 0.4443003
MentalIllness1:age35 to 44 1.08 0.08 1.05 0.2936810
MentalIllness1:age45 to 54 1.07 0.08 0.83 0.4052683
MentalIllness1:age55 to 64 1.03 0.08 0.39 0.6934069
MentalIllness1:age65 or > 65 1.06 0.07 0.84 0.4020568
Alcoholic1 1.17 0.08 2.04 0.0409946
sexMale:Alcoholic1 1.01 0.03 0.24 0.8100267
age25 to 34:Alcoholic1 0.93 0.09 -0.81 0.4166381
age35 to 44:Alcoholic1 0.89 0.09 -1.31 0.1888475
age45 to 54:Alcoholic1 0.98 0.08 -0.30 0.7662691
age55 to 64:Alcoholic1 0.90 0.08 -1.23 0.2175215
age65 or > 65:Alcoholic1 0.91 0.08 -1.27 0.2039775
SubstanceAddiction1 1.07 0.09 0.76 0.4466560
sexMale:SubstanceAddiction1 1.05 0.05 1.04 0.2972658
age25 to 34:SubstanceAddiction1 0.89 0.11 -1.13 0.2568413
age35 to 44:SubstanceAddiction1 0.96 0.10 -0.42 0.6764367
age45 to 54:SubstanceAddiction1 0.87 0.10 -1.33 0.1830669
age55 to 64:SubstanceAddiction1 1.04 0.10 0.34 0.7306433
age65 or > 65:SubstanceAddiction1 0.95 0.10 -0.48 0.6299989
Incarcerated1 0.99 0.09 -0.06 0.9518187
sexMale:Incarcerated1 1.00 0.05 0.07 0.9436445
age25 to 34:Incarcerated1 1.03 0.11 0.30 0.7660570
age35 to 44:Incarcerated1 0.98 0.11 -0.16 0.8746580
age45 to 54:Incarcerated1 1.01 0.11 0.12 0.9033012
age55 to 64:Incarcerated1 0.88 0.11 -1.15 0.2499281
age65 or > 65:Incarcerated1 1.01 0.11 0.14 0.8906266
SeparationDivorce1 0.96 0.07 -0.59 0.5533439
sexMale:SeparationDivorce1 1.01 0.03 0.23 0.8188698
age25 to 34:SeparationDivorce1 0.97 0.08 -0.34 0.7307931
age35 to 44:SeparationDivorce1 1.08 0.07 1.09 0.2767646
age45 to 54:SeparationDivorce1 1.03 0.07 0.41 0.6807284
age55 to 64:SeparationDivorce1 1.07 0.07 0.92 0.3554876
age65 or > 65:SeparationDivorce1 1.05 0.07 0.65 0.5171808
DomesticViolence1 0.89 0.09 -1.37 0.1714862
sexMale:DomesticViolence1 1.07 0.04 1.85 0.0636285
age25 to 34:DomesticViolence1 1.05 0.10 0.44 0.6567417
age35 to 44:DomesticViolence1 0.99 0.10 -0.06 0.9525967
age45 to 54:DomesticViolence1 1.02 0.10 0.25 0.8024837
age55 to 64:DomesticViolence1 1.07 0.09 0.75 0.4545815
age65 or > 65:DomesticViolence1 1.02 0.09 0.25 0.8004073
PhysicalAbuse1 1.03 0.08 0.40 0.6921991
sexMale:PhysicalAbuse1 0.98 0.03 -0.60 0.5503955
age25 to 34:PhysicalAbuse1 1.03 0.09 0.32 0.7501734
age35 to 44:PhysicalAbuse1 0.94 0.09 -0.76 0.4462888
age45 to 54:PhysicalAbuse1 1.03 0.08 0.33 0.7382974
age55 to 64:PhysicalAbuse1 1.10 0.08 1.20 0.2303104
age65 or > 65:PhysicalAbuse1 1.00 0.08 -0.01 0.9889278
EmotionalAbuse1 1.05 0.07 0.77 0.4441457
sexMale:EmotionalAbuse1 1.02 0.03 0.53 0.5939960
age25 to 34:EmotionalAbuse1 0.94 0.08 -0.73 0.4682233
age35 to 44:EmotionalAbuse1 1.05 0.08 0.69 0.4890519
age45 to 54:EmotionalAbuse1 0.98 0.08 -0.32 0.7499410
age55 to 64:EmotionalAbuse1 0.95 0.07 -0.73 0.4637410
age65 or > 65:EmotionalAbuse1 0.97 0.07 -0.41 0.6789239
SexualAbuse11 1.10 0.15 0.65 0.5171426
sexMale:SexualAbuse11 1.04 0.06 0.62 0.5380129
age25 to 34:SexualAbuse11 0.77 0.18 -1.44 0.1506103
age35 to 44:SexualAbuse11 0.94 0.17 -0.39 0.6952884
age45 to 54:SexualAbuse11 0.96 0.16 -0.28 0.7766796
age55 to 64:SexualAbuse11 0.91 0.16 -0.63 0.5276533
age65 or > 65:SexualAbuse11 0.92 0.15 -0.55 0.5791860
SexualAbuse21 0.86 0.17 -0.86 0.3879519
sexMale:SexualAbuse21 1.02 0.06 0.38 0.7067364
age25 to 34:SexualAbuse21 1.54 0.20 2.18 0.0290077
age35 to 44:SexualAbuse21 1.18 0.19 0.87 0.3841571
age45 to 54:SexualAbuse21 1.23 0.18 1.13 0.2572029
age55 to 64:SexualAbuse21 1.18 0.18 0.91 0.3606261
age65 or > 65:SexualAbuse21 1.20 0.17 1.03 0.3039261
SexualAbuse31 1.31 0.15 1.79 0.0739838
sexMale:SexualAbuse31 1.11 0.07 1.46 0.1447136
age25 to 34:SexualAbuse31 0.64 0.18 -2.50 0.0125584
age35 to 44:SexualAbuse31 0.78 0.17 -1.47 0.1419975
age45 to 54:SexualAbuse31 0.60 0.17 -2.95 0.0031994
age55 to 64:SexualAbuse31 0.68 0.17 -2.31 0.0206804
age65 or > 65:SexualAbuse31 0.65 0.16 -2.66 0.0079257
Neglect11 1.32 0.21 1.33 0.1830738
sexMale:Neglect11 0.88 0.09 -1.47 0.1419385
age25 to 34:Neglect11 0.81 0.23 -0.92 0.3561711
age35 to 44:Neglect11 0.85 0.23 -0.72 0.4687265
age45 to 54:Neglect11 0.86 0.23 -0.68 0.4956853
age55 to 64:Neglect11 1.04 0.23 0.16 0.8695579
age65 or > 65:Neglect11 0.82 0.21 -0.94 0.3471280
Neglect21 0.58 0.35 -1.53 0.1250465
sexMale:Neglect21 1.30 0.16 1.68 0.0928599
age25 to 34:Neglect21 1.63 0.38 1.28 0.2012412
age35 to 44:Neglect21 2.36 0.40 2.13 0.0329828
age45 to 54:Neglect21 1.46 0.38 1.01 0.3115467
age55 to 64:Neglect21 1.05 0.36 0.13 0.8968641
age65 or > 65:Neglect21 1.51 0.34 1.20 0.2310105

     

Discussion

Shown in Figure 7, we see the average number of days alcohol was consumed per month for all categories in the data set where 15 or more observations were seen for each subset category (gender, categories, and age group), which shows little evidence that those with more ACEs that also include rape drink on average more or less days compared to those with fewer ACE that also include rape in addition to those who report a history of no ACEs. It should be noted that potentially because this is such a sensitive topic, there is not a large number of people used in both this analysis and this figure.

Interestingly, Figures 9 shows those with only a history of parental separation or divorce, physical abuse, or domestic violence report on average fewer days were alcohol is consumed per month compared to those that report no history of any ACE which is shown to continue as a trend in Figure 9, 10, 11, 12, and 13.

     

Figure 7
History of Rape and Average Days Per Month Alcohol is Consumed

Note. SA2 = sexual abuse 2 (i.e., forced to sexually touch abuser). A = alcohol misuse in household. SubAddic = substance addiction in the household. PA = physical abuse. SA1 = sexual abuse 1 (i.e., molestation). None = respondent did not report any ACE. S/D = parental separation or divorce. MI = mental illness in the household. EA = emotional abuse. I = incarcerated household member. SA3 = sexual abuse 3 (i.e., rape). N1 = neglect 1 (i.e., no adult in household who made them feel safe and protected). N2 = neglect 2 (i.e., no adult in household who tried hard to make sure their basic needs were met). DV = domestic violence in the household.

Figure 8
History of 1 Adverse Childhood Event and Average Days Where Alcohol is Consumed Per Month

Note. SA2 = sexual abuse 2 (i.e., forced to sexually touch abuser). A = alcohol misuse in household. SubAddic = substance addiction in the household. PA = physical abuse. SA1 = sexual abuse 1 (i.e., molestation). None = respondent did not report any ACE. S/D = parental separation or divorce. MI = mental illness in the household. EA = emotional abuse. I = incarcerated household member. SA3 = sexual abuse 3 (i.e., rape). N1 = neglect 1 (i.e., no adult in household who made them feel safe and protected). N2 = neglect 2 (i.e., no adult in household who tried hard to make sure their basic needs were met). DV = domestic violence in the household.

Figure 9
History of 2 Adverse Childhood Events and Average Days Where Alcohol is Consumed Per Month

Note. SA2 = sexual abuse 2 (i.e., forced to sexually touch abuser). A = alcohol misuse in household. SubAddic = substance addiction in the household. PA = physical abuse. SA1 = sexual abuse 1 (i.e., molestation). None = respondent did not report any ACE. S/D = parental separation or divorce. MI = mental illness in the household. EA = emotional abuse. I = incarcerated household member. SA3 = sexual abuse 3 (i.e., rape). N1 = neglect 1 (i.e., no adult in household who made them feel safe and protected). N2 = neglect 2 (i.e., no adult in household who tried hard to make sure their basic needs were met). DV = domestic violence in the household.

Figure 10
History of 2 Adverse Childhood Events and Average Days Where Alcohol is Consumed Per Month

Note. SA2 = sexual abuse 2 (i.e., forced to sexually touch abuser). A = alcohol misuse in household. SubAddic = substance addiction in the household. PA = physical abuse. SA1 = sexual abuse 1 (i.e., molestation). None = respondent did not report any ACE. S/D = parental separation or divorce. MI = mental illness in the household. EA = emotional abuse. I = incarcerated household member. SA3 = sexual abuse 3 (i.e., rape). N1 = neglect 1 (i.e., no adult in household who made them feel safe and protected). N2 = neglect 2 (i.e., no adult in household who tried hard to make sure their basic needs were met). DV = domestic violence in the household.

Figure 11
History of 3 Adverse Childhood Events and Average Days Where Alcohol is Consumed Per Month

Note. SA2 = sexual abuse 2 (i.e., forced to sexually touch abuser). A = alcohol misuse in household. SubAddic = substance addiction in the household. PA = physical abuse. SA1 = sexual abuse 1 (i.e., molestation). None = respondent did not report any ACE. S/D = parental separation or divorce. MI = mental illness in the household. EA = emotional abuse. I = incarcerated household member. SA3 = sexual abuse 3 (i.e., rape). N1 = neglect 1 (i.e., no adult in household who made them feel safe and protected). N2 = neglect 2 (i.e., no adult in household who tried hard to make sure their basic needs were met). DV = domestic violence in the household.

Figure 12
History of 4 Adverse Childhood Events and Average Days Where Alcohol is Consumed Per Month

Note. SA2 = sexual abuse 2 (i.e., forced to sexually touch abuser). A = alcohol misuse in household. SubAddic = substance addiction in the household. PA = physical abuse. SA1 = sexual abuse 1 (i.e., molestation). None = respondent did not report any ACE. S/D = parental separation or divorce. MI = mental illness in the household. EA = emotional abuse. I = incarcerated household member. SA3 = sexual abuse 3 (i.e., rape). N1 = neglect 1 (i.e., no adult in household who made them feel safe and protected). N2 = neglect 2 (i.e., no adult in household who tried hard to make sure their basic needs were met). DV = domestic violence in the household.

Figure 13
History of 5 or More Adverse Childhood Events and Average Days Where Alcohol is Consumed Per Month

Note. SA2 = sexual abuse 2 (i.e., forced to sexually touch abuser). A = alcohol misuse in household. SubAddic = substance addiction in the household. PA = physical abuse. SA1 = sexual abuse 1 (i.e., molestation). None = respondent did not report any ACE. S/D = parental separation or divorce. MI = mental illness in the household. EA = emotional abuse. I = incarcerated household member. SA3 = sexual abuse 3 (i.e., rape). N1 = neglect 1 (i.e., no adult in household who made them feel safe and protected). N2 = neglect 2 (i.e., no adult in household who tried hard to make sure their basic needs were met). DV = domestic violence in the household.

     

Occasions of binge drinking in the past month

The third question refers to the number of occasions in the past month where 5 or more alcoholic drinks are consumed if male or 4 or more alcoholic drinks are consumed if female. The CDC classifies 4 or more for females and 5 or more for males as excessive alcohol use or binge drinking. This question was only asked if the respondent indicated they consumed alcohol.

Like in the past two questions, the first equation seen below is the final model used to predict the average number of occasions in the past month where binge drinking occurred while the second equation includes the \(\beta\) estimates which are all rounded to two decimal places.

\[\begin{align*} ln(\lambda) =& \\ &\beta_0 + \\ &\beta_1 (\text{Male}) + \\ &\beta_2 (\text{25 to 34}) + \beta_3 (\text{35 to 44}) + \beta_4 (\text{45 to 54}) + \beta_5 (\text{55 to 64}) + \beta_6 (\text{18 to 24}) + \\ &\beta_7 (\text{MentalIllness}) + \beta_8 (\text{MentalIllness} \cdot \text{25 to 34}) + \beta_9 (\text{MentalIllness} \cdot \text{35 to 44}) + \beta_{10} (\text{MentalIllness} \cdot \text{45 to 54}) + \\ &\qquad \beta_{11} (\text{MentalIllness} \cdot \text{55 to 64}) + \beta_{12} (\text{MentalIllness} \cdot \text{18 to 24}) + \beta_{13} (\text{MentalIllness} \cdot \text{Male}) + \\ &\beta_{14} (\text{Alcohol}) + \beta_{15} (\text{Alcohol} \cdot \text{25 to 34}) + \beta_{16} (\text{Alcohol} \cdot \text{35 to 44}) + \beta_{17} (\text{Alcohol} \cdot \text{45 to 54}) + \\ &\qquad \beta_{18} (\text{Alcohol} \cdot \text{55 to 64}) + \beta_{19} (\text{Alcohol} \cdot \text{18 to 24}) + \beta_{20} (\text{Alcohol} \cdot \text{Male}) + \\ &\beta_{21} (\text{SubstanceAddiction}) + \beta_{22} (\text{SubstanceAddiction} \cdot \text{25 to 34}) + \beta_{23} (\text{SubstanceAddiction} \cdot \text{35 to 44}) + \\ &\qquad \beta_{24} (\text{SubstanceAddiction} \cdot \text{45 to 54}) + \beta_{25} (\text{SubstanceAddiction} \cdot \text{55 to 64}) + \\ &\qquad \beta_{26} (\text{SubstanceAddiction} \cdot \text{18 to 24}) + \beta_{27} (\text{SubstanceAddiction} \cdot \text{Male}) + \\ &\beta_{28} (\text{Incarcerated}) + \beta_{29} (\text{Incarcerated} \cdot \text{25 to 34}) + \beta_{30} (\text{Incarcerated} \cdot \text{35 to 44}) + \beta_{31} (\text{Incarcerated} \cdot \text{45 to 54}) + \\ &\qquad \beta_{32} (\text{Incarcerated} \cdot \text{55 to 64}) + \beta_{32} (\text{Incarcerated} \cdot \text{18 to 24}) + \beta_{33} (\text{Incarcerated} \cdot \text{Male}) + \\ &\beta_{34} (\text{SeparationDivorce}) + \beta_{35} (\text{SeparationDivorce} \cdot \text{25 to 34}) + \beta_{36} (\text{SeparationDivorce} \cdot \text{35 to 44}) + \\ &\qquad \beta_{37} (\text{SeparationDivorce} \cdot \text{45 to 54}) + \beta_{38} (\text{SeparationDivorce} \cdot \text{55 to 64}) + \\ &\qquad \beta_{39} (\text{SeparationDivorce} \cdot \text{18 to 24}) + \beta_{40} (\text{SeparationDivorce} \cdot \text{Male}) + \\ &\beta_{41} (\text{DomesticViolence}) + \beta_{42} (\text{DomesticViolence} \cdot \text{25 to 34}) + \beta_{43} (\text{DomesticViolence} \cdot \text{35 to 44}) + \\ &\qquad \beta_{44} (\text{DomesticViolence} \cdot \text{45 to 54}) + \beta_{45} (\text{DomesticViolence} \cdot \text{55 to 64}) + \\ &\qquad \beta_{46} (\text{DomesticViolence} \cdot \text{18 to 24}) + \beta_{47} (\text{DomesticViolence} \cdot \text{Male}) + \\ &\beta_{48} (\text{PhysicalAbuse}) + \beta_{49} (\text{PhysicalAbuse} \cdot \text{25 to 34}) + \beta_{50} (\text{PhysicalAbuse} \cdot \text{35 to 44}) + \\ &\qquad \beta_{51} (\text{PhysicalAbuse} \cdot \text{45 to 54}) + \beta_{52} (\text{PhysicalAbuse} \cdot \text{55 to 64}) + \\ &\qquad \beta_{53} (\text{PhysicalAbuse} \cdot \text{18 to 24}) + \beta_{54} (\text{PhysicalAbuse} \cdot \text{Male}) + \\ &\beta_{55} (\text{EmotionalAbuse}) + \beta_{56} (\text{EmotionalAbuse} \cdot \text{25 to 34}) + \beta_{57} (\text{EmotionalAbuse} \cdot \text{35 to 44}) + \\ &\qquad \beta_{58} (\text{EmotionalAbuse} \cdot \text{45 to 54}) + \beta_{59} (\text{EmotionalAbuse} \cdot \text{55 to 64}) + \\ &\qquad \beta_{60} (\text{EmotionalAbuse} \cdot \text{18 to 24}) + \beta_{61} (\text{EmotionalAbuse} \cdot \text{Male}) + \\ &\beta_{62} (\text{SexualAbuse1}) + \beta_{63} (\text{SexualAbuse1} \cdot \text{25 to 34}) + \beta_{64} (\text{SexualAbuse1} \cdot \text{35 to 44}) + \\ &\qquad \beta_{65} (\text{SexualAbuse1} \cdot \text{45 to 54}) + \beta_{66} (\text{SexualAbuse1} \cdot \text{55 to 64}) + \\ &\qquad \beta_{67} (\text{SexualAbuse1} \cdot \text{18 to 24}) + \beta_{68} (\text{SexualAbuse1} \cdot \text{Male}) + \\ &\beta_{69} (\text{SexualAbuse2}) + \beta_{70} (\text{SexualAbuse2} \cdot \text{25 to 34}) + \beta_{71} (\text{SexualAbuse2} \cdot \text{35 to 44}) + \\ &\qquad \beta_{72} (\text{SexualAbuse2} \cdot \text{45 to 54}) + \beta_{73} (\text{SexualAbuse2} \cdot \text{55 to 64}) + \\ &\qquad \beta_{74} (\text{SexualAbuse2} \cdot \text{18 to 24}) + \beta_{75} (\text{SexualAbuse2} \cdot \text{Male}) + \\ &\beta_{76} (\text{SexualAbuse3}) + \beta_{77} (\text{SexualAbuse3} \cdot \text{25 to 34}) + \beta_{78} (\text{SexualAbuse3} \cdot \text{35 to 44}) + \\ &\qquad \beta_{79} (\text{SexualAbuse3} \cdot \text{45 to 54}) + \beta_{80} (\text{SexualAbuse3} \cdot \text{55 to 64}) + \\ &\qquad \beta_{81} (\text{SexualAbuse3} \cdot \text{18 to 24}) + \beta_{82} (\text{SexualAbuse3} \cdot \text{Male}) + \\ &\beta_{83} (\text{Neglect1}) + \beta_{84} (\text{Neglect1} \cdot \text{25 to 34}) + \beta_{85} (\text{Neglect1} \cdot \text{35 to 44}) + \beta_{86} (\text{Neglect1} \cdot \text{45 to 54}) + \\ &\qquad \beta_{87} (\text{Neglect1} \cdot \text{55 to 64}) + \beta_{88} (\text{Neglect1} \cdot \text{18 to 24}) + \beta_{89} (\text{Neglect1} \cdot \text{Male}) + \\ &\beta_{90} (\text{Neglect2}) + \beta_{91} (\text{Neglect2} \cdot \text{25 to 34}) + \beta_{92} (\text{Neglect2} \cdot \text{35 to 44}) + \beta_{93} (\text{Neglect2} \cdot \text{45 to 54}) + \\ &\qquad \beta_{94} (\text{Neglect2} \cdot \text{55 to 64}) + \beta_{95} (\text{Neglect2} \cdot \text{18 to 24}) + \beta_{96} (\text{Neglect2} \cdot \text{Male}) + \\ \end{align*}\] \[\begin{align*} ln(\lambda) =& \\ &6.85 + \\ &1.06 (\text{Male}) + \\ &0.59 (\text{25 to 34}) + 0.48 (\text{35 to 44}) + 0.59 (\text{45 to 54}) + 1.03 (\text{55 to 64}) + 1.80 (\text{18 to 24}) + \\ &0.95 (\text{MentalIllness}) + 1.08 (\text{MentalIllness} \cdot \text{25 to 34}) + 1.13 (\text{MentalIllness} \cdot \text{35 to 44}) + 1.15 (\text{MentalIllness} \cdot \text{45 to 54}) + \\ &\qquad 1.30 (\text{MentalIllness} \cdot \text{55 to 64}) + 1.08 (\text{MentalIllness} \cdot \text{18 to 24}) + 0.97 (\text{MentalIllness} \cdot \text{Male}) + \\ &1.23 (\text{Alcohol}) + 0.99 (\text{Alcohol} \cdot \text{25 to 34}) + 0.82 (\text{Alcohol} \cdot \text{35 to 44}) + 0.89 (\text{Alcohol} \cdot \text{45 to 54}) + \\ &\qquad 0.88 (\text{Alcohol} \cdot \text{55 to 64}) + 0.98 (\text{Alcohol} \cdot \text{18 to 24}) + 1.03 (\text{Alcohol} \cdot \text{Male}) + \\ &1.23 (\text{SubstanceAddiction}) + 0.87 (\text{SubstanceAddiction} \cdot \text{25 to 34}) + 0.86 (\text{SubstanceAddiction} \cdot \text{35 to 44}) + \\ &\qquad 0.99 (\text{SubstanceAddiction} \cdot \text{45 to 54}) + 0.89 (\text{SubstanceAddiction} \cdot \text{55 to 64}) + \\ &\qquad 0.88 (\text{SubstanceAddiction} \cdot \text{18 to 24}) + 0.91 (\text{SubstanceAddiction} \cdot \text{Male}) + \\ &1.24 (\text{Incarcerated}) + 0.97 (\text{Incarcerated} \cdot \text{25 to 34}) + 0.88 (\text{Incarcerated} \cdot \text{35 to 44}) + 0.77 (\text{Incarcerated} \cdot \text{45 to 54}) + \\ &\qquad 0.73 (\text{Incarcerated} \cdot \text{55 to 64}) + 0.80 (\text{Incarcerated} \cdot \text{18 to 24}) + 1.12 (\text{Incarcerated} \cdot \text{Male}) + \\ &1.01 (\text{SeparationDivorce}) + 1.01 (\text{SeparationDivorce} \cdot \text{25 to 34}) + 1.05 (\text{SeparationDivorce} \cdot \text{35 to 44}) + \\ &\qquad 1.00 (\text{SeparationDivorce} \cdot \text{45 to 54}) + 1.24 (\text{SeparationDivorce} \cdot \text{55 to 64}) + \\ &\qquad 0.97 (\text{SeparationDivorce} \cdot \text{18 to 24}) + 0.96 (\text{SeparationDivorce} \cdot \text{Male}) + \\ &0.92 (\text{DomesticViolence}) + 0.99 (\text{DomesticViolence} \cdot \text{25 to 34}) + 1.14 (\text{DomesticViolence} \cdot \text{35 to 44}) + \\ &\qquad 1.12 (\text{DomesticViolence} \cdot \text{45 to 54}) + 1.07 (\text{DomesticViolence} \cdot \text{55 to 64}) + \\ &\qquad 0.89 (\text{DomesticViolence} \cdot \text{18 to 24}) + 0.99 (\text{DomesticViolence} \cdot \text{Male}) + \\ &1.02 (\text{PhysicalAbuse}) + 1.23 (\text{PhysicalAbuse} \cdot \text{25 to 34}) + 0.94 (\text{PhysicalAbuse} \cdot \text{35 to 44}) + \\ &\qquad 1.12 (\text{PhysicalAbuse} \cdot \text{45 to 54}) + 0.99 (\text{PhysicalAbuse} \cdot \text{55 to 64}) + \\ &\qquad 1.11 (\text{PhysicalAbuse} \cdot \text{18 to 24}) + 1.05 (\text{PhysicalAbuse} \cdot \text{Male}) + \\ &0.86 (\text{EmotionalAbuse}) + 1.16 (\text{EmotionalAbuse} \cdot \text{25 to 34}) + 1.24 (\text{EmotionalAbuse} \cdot \text{35 to 44}) + \\ &\qquad 1.26 (\text{EmotionalAbuse} \cdot \text{45 to 54}) + 1.28 (\text{EmotionalAbuse} \cdot \text{55 to 64}) + \\ &\qquad 1.11 (\text{EmotionalAbuse} \cdot \text{18 to 24}) + 1.01 (\text{EmotionalAbuse} \cdot \text{Male}) + \\ &0.97 (\text{SexualAbuse1}) + 1.02 (\text{SexualAbuse1} \cdot \text{25 to 34}) + 0.98 (\text{SexualAbuse1} \cdot \text{35 to 44}) + \\ &\qquad 1.15 (\text{SexualAbuse1} \cdot \text{45 to 54}) + 0.90 (\text{SexualAbuse1} \cdot \text{55 to 64}) + \\ &\qquad 0.90 (\text{SexualAbuse1} \cdot \text{18 to 24}) + 1.36 (\text{SexualAbuse1} \cdot \text{Male}) + \\ &1.46 (\text{SexualAbuse2}) + 1.03 (\text{SexualAbuse2} \cdot \text{25 to 34}) + 1.00 (\text{SexualAbuse2} \cdot \text{35 to 44}) + \\ &\qquad 0.74 (\text{SexualAbuse2} \cdot \text{45 to 54}) + 0.81 (\text{SexualAbuse2} \cdot \text{55 to 64}) + \\ &\qquad 0.89 (\text{SexualAbuse2} \cdot \text{18 to 24}) + 0.80 (\text{SexualAbuse2} \cdot \text{Male}) + \\ &1.11 (\text{SexualAbuse3}) + 0.64 (\text{SexualAbuse3} \cdot \text{25 to 34}) + 0.99 (\text{SexualAbuse3} \cdot \text{35 to 44}) + \\ &\qquad 1.01 (\text{SexualAbuse3} \cdot \text{45 to 54}) + 0.83 (\text{SexualAbuse3} \cdot \text{55 to 64}) + \\ &\qquad 1.04 (\text{SexualAbuse3} \cdot \text{18 to 24}) + 0.94 (\text{SexualAbuse3} \cdot \text{Male}) + \\ &0.68 (\text{Neglect1}) + 1.10 (\text{Neglect1} \cdot \text{25 to 34}) + 1.75 (\text{Neglect1} \cdot \text{35 to 44}) + 1.08 (\text{Neglect1} \cdot \text{45 to 54}) + \\ &\qquad 1.55 (\text{Neglect1} \cdot \text{55 to 64}) + 1.06 (\text{Neglect1} \cdot \text{18 to 24}) + 1.32 (\text{Neglect1} \cdot \text{Male}) + \\ &0.84 (\text{Neglect2}) + 1.02 (\text{Neglect2} \cdot \text{25 to 34}) + 1.00 (\text{Neglect2} \cdot \text{35 to 44}) + 1.27 (\text{Neglect2} \cdot \text{45 to 54}) + \\ &\qquad 0.55 (\text{Neglect2} \cdot \text{55 to 64}) + 0.37 (\text{Neglect2} \cdot \text{18 to 24}) + 1.04 (\text{Neglect2} \cdot \text{Male}) + \\ \end{align*}\]

Interpretation

In a month females 65 and older with no history of any ACE on average are shown to drink 4 or more alcoholic drinks on 6.85 occasions (\(\beta_0 = 6.85\), \(SE = 0.28\), \(t = 6.83\), \(p < .000001\)). Those who report being a male are not shown to have any increased or decreased risk for the number of occasions where 5 or more drinks are consumed compared to females 65 and older with no history of any ACE (\(\beta_1 = 1.06\), \(SE = 0.23\), \(t = 0.23\), \(p = .605\)).

Those that report being between the ages of 18 to 24 (\(\beta_6 = 1.80\), \(SE = 0.34\), \(t = 1.70\), \(p = .089\)), 25 to 34 (\(\beta_2 = 0.59\), \(SE = 0.31\), \(t = -1.69\), \(p = .092\)), 35 to 44 (\(\beta_3 = 0.48\), \(SE = 0.36\), \(t = -2.02\), \(p = .043\)), 45 to 54 (\(\beta_4 = 0.59\), \(SE = 0.34\), \(t = -1.56\), \(p = 0.118\)), or 55 to 64 (\(\beta_5 = 1.03\), \(SE = 0.32\), \(t = 0.10\), \(p = .922\)) are not shown to differ in occasions per month where binge drinking is observed compared to those that are females 65 and older with no history of any ACE.

Those that are male and report a history of sexual assault (someone sexually touching the respondent) are shown to have 1.36 times more occasions per month where the person is binge drinking compared to females 65 and older with no history of any ACE (\(\beta_{68} = 1.36\), \(SE = 0.11\), \(t = 2.81\), \(p = .005\)). Those who report being male along with a history of either mental illness in the household, or alcohol misuse in the household, or substance addiction in the household, or a history of someone forcing the respondent to touch someone else sexually, or having a household member incarcerated, or parental separation or divorce, or domestic violence in the household, or physical abuse, or emotional abuse, or rape, or neglect of any kind, were not seen to increase or decrease occasions per month where the person is binge drinking compared to females 65 and older with no history of any ACE (see Table 5 for further information).

Those that report a history of emotional abuse and that are also between the ages of 55 to 64 (\(\beta_{59} = 1.28\), \(SE = 0.09\), \(t = 2.69\), \(p = .007\)) are shown to have 1.28 times more occasions per month where the person is binge drinking compared to females 65 and older with no history of any ACE, but those between the ages of 18 to 24, or 25 to 34, or 35 to 44, or 45 to 54 are not shown to effect the number of occasions per month where binge drinking occurs compared to females 65 and older with no history of any ACE (see Table 5 for further information).

Those that report no adult in your household who tried hard to make sure their basic needs were met (i.e., Neglect2) that were also between the ages of 18 to 24 were shown to have 0.37 times lower number of occasions per month where the person was binge drinking compared to females 65 and older with no history of any ACE (\(\beta_{95} = 0.37\), \(SE = 0.35\), \(t = -2.82\), \(p = .005\)). The interaction between this ACE and other age category were not shown to effect the number of occasions per month where binge drinking occurs compared to females 65 and older with no history of any ACE (see Table 5 for further information).

All other interactions between the other 10 ACEs and age categories were shown not to differ in relative risk for average occasions to binge drink in the past month compared to females 65 and older that report no history of an ACE (see Table 5 for further information).

Table 5
Estimates for ACE Terms and Interactions

Table
term estimate std.error statistic p.value
MentalIllness1 0.95 0.11 -0.52 0.6045047
MentalIllness1:sexMale 0.97 0.07 -0.49 0.6253371
MentalIllness1:age55 to 64 1.30 0.13 2.09 0.0364876
MentalIllness1:age45 to 54 1.15 0.12 1.12 0.2631564
MentalIllness1:age35 to 44 1.13 0.12 1.05 0.2919040
MentalIllness1:age25 to 34 1.08 0.12 0.59 0.5532210
MentalIllness1:age18 to 24 1.08 0.14 0.56 0.5755820
Alcoholic1 1.23 0.08 2.48 0.0129893
sexMale:Alcoholic1 1.03 0.06 0.45 0.6523434
age55 to 64:Alcoholic1 0.88 0.10 -1.34 0.1794802
age45 to 54:Alcoholic1 0.89 0.10 -1.14 0.2524945
age35 to 44:Alcoholic1 0.82 0.10 -1.96 0.0497948
age25 to 34:Alcoholic1 0.99 0.10 -0.07 0.9446615
age18 to 24:Alcoholic1 0.98 0.13 -0.19 0.8471420
SubstanceAddiction1 1.23 0.13 1.63 0.1034136
sexMale:SubstanceAddiction1 0.91 0.08 -1.14 0.2547600
age55 to 64:SubstanceAddiction1 0.89 0.15 -0.75 0.4522852
age45 to 54:SubstanceAddiction1 0.99 0.15 -0.08 0.9401698
age35 to 44:SubstanceAddiction1 0.86 0.14 -1.04 0.2995278
age25 to 34:SubstanceAddiction1 0.87 0.15 -0.96 0.3374740
age18 to 24:SubstanceAddiction1 0.88 0.17 -0.74 0.4610097
Incarcerated1 1.24 0.15 1.41 0.1583067
sexMale:Incarcerated1 1.12 0.09 1.23 0.2201420
age55 to 64:Incarcerated1 0.73 0.18 -1.77 0.0772267
age45 to 54:Incarcerated1 0.77 0.17 -1.53 0.1250881
age35 to 44:Incarcerated1 0.88 0.16 -0.81 0.4185404
age25 to 34:Incarcerated1 0.97 0.16 -0.19 0.8519357
age18 to 24:Incarcerated1 0.80 0.19 -1.19 0.2355937
SeparationDivorce1 1.01 0.09 0.13 0.8962249
sexMale:SeparationDivorce1 0.96 0.06 -0.62 0.5365945
age55 to 64:SeparationDivorce1 1.24 0.10 2.04 0.0417021
age45 to 54:SeparationDivorce1 1.00 0.10 0.04 0.9665658
age35 to 44:SeparationDivorce1 1.05 0.10 0.53 0.5986629
age25 to 34:SeparationDivorce1 1.01 0.11 0.06 0.9499373
age18 to 24:SeparationDivorce1 0.97 0.12 -0.21 0.8298110
DomesticViolence1 0.92 0.11 -0.76 0.4454244
sexMale:DomesticViolence1 0.99 0.07 -0.18 0.8539444
age55 to 64:DomesticViolence1 1.07 0.12 0.54 0.5915686
age45 to 54:DomesticViolence1 1.12 0.12 0.95 0.3426742
age35 to 44:DomesticViolence1 1.14 0.12 1.08 0.2817809
age25 to 34:DomesticViolence1 0.99 0.13 -0.07 0.9461055
age18 to 24:DomesticViolence1 0.89 0.15 -0.77 0.4437516
PhysicalAbuse1 1.02 0.09 0.18 0.8552354
sexMale:PhysicalAbuse1 1.05 0.07 0.80 0.4226329
age55 to 64:PhysicalAbuse1 0.99 0.10 -0.15 0.8813659
age45 to 54:PhysicalAbuse1 1.12 0.10 1.15 0.2505971
age35 to 44:PhysicalAbuse1 0.94 0.10 -0.63 0.5314782
age25 to 34:PhysicalAbuse1 1.23 0.10 1.98 0.0475147
age18 to 24:PhysicalAbuse1 1.11 0.13 0.79 0.4304223
EmotionalAbuse1 0.86 0.08 -1.78 0.0745504
sexMale:EmotionalAbuse1 1.01 0.06 0.11 0.9094358
age55 to 64:EmotionalAbuse1 1.28 0.09 2.68 0.0074265
age45 to 54:EmotionalAbuse1 1.26 0.09 2.52 0.0118429
age35 to 44:EmotionalAbuse1 1.24 0.09 2.31 0.0209111
age25 to 34:EmotionalAbuse1 1.16 0.10 1.46 0.1432695
age18 to 24:EmotionalAbuse1 1.11 0.12 0.89 0.3727485
SexualAbuse11 0.97 0.14 -0.20 0.8390473
sexMale:SexualAbuse11 1.36 0.11 2.81 0.0049145
age55 to 64:SexualAbuse11 0.90 0.17 -0.62 0.5340018
age45 to 54:SexualAbuse11 1.15 0.17 0.84 0.3994274
age35 to 44:SexualAbuse11 0.98 0.18 -0.09 0.9312144
age25 to 34:SexualAbuse11 1.02 0.20 0.12 0.9066515
age18 to 24:SexualAbuse11 0.90 0.25 -0.41 0.6845509
SexualAbuse21 1.46 0.16 2.39 0.0166360
sexMale:SexualAbuse21 0.80 0.12 -1.86 0.0626802
age55 to 64:SexualAbuse21 0.81 0.20 -1.04 0.2972842
age45 to 54:SexualAbuse21 0.74 0.19 -1.52 0.1280357
age35 to 44:SexualAbuse21 1.00 0.20 -0.02 0.9830299
age25 to 34:SexualAbuse21 1.03 0.21 0.15 0.8820300
age18 to 24:SexualAbuse21 0.89 0.28 -0.40 0.6912434
SexualAbuse31 1.11 0.19 0.55 0.5828948
sexMale:SexualAbuse31 0.94 0.13 -0.50 0.6161484
age55 to 64:SexualAbuse31 0.83 0.24 -0.78 0.4350715
age45 to 54:SexualAbuse31 1.01 0.22 0.05 0.9637962
age35 to 44:SexualAbuse31 0.99 0.23 -0.05 0.9568961
age25 to 34:SexualAbuse31 0.64 0.24 -1.85 0.0637591
age18 to 24:SexualAbuse31 1.04 0.27 0.15 0.8829949
Neglect11 0.68 0.21 -1.87 0.0615613
sexMale:Neglect11 1.32 0.17 1.63 0.1034469
age55 to 64:Neglect11 1.55 0.26 1.67 0.0945568
age45 to 54:Neglect11 1.08 0.24 0.34 0.7362273
age35 to 44:Neglect11 1.75 0.26 2.17 0.0300673
age25 to 34:Neglect11 1.10 0.25 0.39 0.6993471
age18 to 24:Neglect11 1.06 0.27 0.21 0.8334310
Neglect21 0.84 0.31 -0.55 0.5804651
sexMale:Neglect21 1.04 0.24 0.16 0.8697309
age55 to 64:Neglect21 0.55 0.33 -1.83 0.0666285
age45 to 54:Neglect21 1.27 0.37 0.65 0.5154441
age35 to 44:Neglect21 1.00 0.38 0.01 0.9947447
age25 to 34:Neglect21 1.02 0.35 0.05 0.9623147
age18 to 24:Neglect21 0.37 0.35 -2.82 0.0047503

     

Discussion

Figure 14 shows that ACEs that also include a history of sexual molestation (SA1) have higher average occasions of binge drinking per month compared to those who only have a history of sexual molestation or report no history of adversity. Also, it does appear that there is high variability for the mean points in this figure between males and females (if there are 15 or more that make up the same gender age group and history of adversities), were shown to report relatively the same average number of occasions of binge drinking per month.

Figure 15 shows that generally that those reporting a history of emotional abuse had higher avergae number of occasions per month of binge drinking compared to those who report no history of any ACEs. There is less of a pattern here that shows those with a history of more ACEs that also include emotional abuse to have higher average occasions per month where binge drinking occurs.

Figure 16 shows that generally those that report a history of neglect (N2) are shown to have more occasions per month where binge drinking occurs compared to those that report no history of any ACEs. Fascinatingly, this figure shows that that report just a history of neglect (N2) were shown to have the second highest average of occasions where binge drinking occurs per month out of the 21 other categories in this figure that also list a history of neglect (N2), which is demonstrating the opposite of more ACEs resulting in higher levels of impulsive and maladaptive behavior.

Figure 17, 18, 19, 20, 21, and 22 demonstrate relatively similar behavior for occasions per month where binge drinking occurs with those that report a history of any ACEs typically having the lowest number of occasions of binge drinking per month.

     

Figure 14
Sexual Abuse (SA2) and Occasions of Binge Drinking Per Month

Note. SA2 = sexual abuse 2 (i.e., forced to sexually touch abuser). A = alcohol misuse in household. SubAddic = substance addiction in the household. PA = physical abuse. SA1 = sexual abuse 1 (i.e., molestation). None = respondent did not report any ACE. S/D = parental separation or divorce. MI = mental illness in the household. EA = emotional abuse. I = incarcerated household member. SA3 = sexual abuse 3 (i.e., rape). N1 = neglect 1 (i.e., no adult in household who made them feel safe and protected). N2 = neglect 2 (i.e., no adult in household who tried hard to make sure their basic needs were met). DV = domestic violence in the household.

Figure 15
Emotional Abuse and Occasions of Binge Drinking Per Month

Note. SA2 = sexual abuse 2 (i.e., forced to sexually touch abuser). A = alcohol misuse in household. SubAddic = substance addiction in the household. PA = physical abuse. SA1 = sexual abuse 1 (i.e., molestation). None = respondent did not report any ACE. S/D = parental separation or divorce. MI = mental illness in the household. EA = emotional abuse. I = incarcerated household member. SA3 = sexual abuse 3 (i.e., rape). N1 = neglect 1 (i.e., no adult in household who made them feel safe and protected). N2 = neglect 2 (i.e., no adult in household who tried hard to make sure their basic needs were met). DV = domestic violence in the household.

Figure 16
Neglect (N2) and Occasions of Binge Drinking Per Month

Note. SA2 = sexual abuse 2 (i.e., forced to sexually touch abuser). A = alcohol misuse in household. SubAddic = substance addiction in the household. PA = physical abuse. SA1 = sexual abuse 1 (i.e., molestation). None = respondent did not report any ACE. S/D = parental separation or divorce. MI = mental illness in the household. EA = emotional abuse. I = incarcerated household member. SA3 = sexual abuse 3 (i.e., rape). N1 = neglect 1 (i.e., no adult in household who made them feel safe and protected). N2 = neglect 2 (i.e., no adult in household who tried hard to make sure their basic needs were met). DV = domestic violence in the household.

Figure 17
History of 1 Adverse Childhood Event and Average Occasions of Binge Drinking Per Month

Note. SA2 = sexual abuse 2 (i.e., forced to sexually touch abuser). A = alcohol misuse in household. SubAddic = substance addiction in the household. PA = physical abuse. SA1 = sexual abuse 1 (i.e., molestation). None = respondent did not report any ACE. S/D = parental separation or divorce. MI = mental illness in the household. EA = emotional abuse. I = incarcerated household member. SA3 = sexual abuse 3 (i.e., rape). N1 = neglect 1 (i.e., no adult in household who made them feel safe and protected). N2 = neglect 2 (i.e., no adult in household who tried hard to make sure their basic needs were met). DV = domestic violence in the household.

Figure 18
History of 2 Adverse Childhood Events and Average Occasions of Binge Drinking Per Month

Note. SA2 = sexual abuse 2 (i.e., forced to sexually touch abuser). A = alcohol misuse in household. SubAddic = substance addiction in the household. PA = physical abuse. SA1 = sexual abuse 1 (i.e., molestation). None = respondent did not report any ACE. S/D = parental separation or divorce. MI = mental illness in the household. EA = emotional abuse. I = incarcerated household member. SA3 = sexual abuse 3 (i.e., rape). N1 = neglect 1 (i.e., no adult in household who made them feel safe and protected). N2 = neglect 2 (i.e., no adult in household who tried hard to make sure their basic needs were met). DV = domestic violence in the household.

Figure 19
History of 3 Adverse Childhood Events and Average Occasions of Binge Drinking Per Month

Note. SA2 = sexual abuse 2 (i.e., forced to sexually touch abuser). A = alcohol misuse in household. SubAddic = substance addiction in the household. PA = physical abuse. SA1 = sexual abuse 1 (i.e., molestation). None = respondent did not report any ACE. S/D = parental separation or divorce. MI = mental illness in the household. EA = emotional abuse. I = incarcerated household member. SA3 = sexual abuse 3 (i.e., rape). N1 = neglect 1 (i.e., no adult in household who made them feel safe and protected). N2 = neglect 2 (i.e., no adult in household who tried hard to make sure their basic needs were met). DV = domestic violence in the household.

Figure 20
History of 4 Adverse Childhood Events and Average Occasions of Binge Drinking Per Month

Note. SA2 = sexual abuse 2 (i.e., forced to sexually touch abuser). A = alcohol misuse in household. SubAddic = substance addiction in the household. PA = physical abuse. SA1 = sexual abuse 1 (i.e., molestation). None = respondent did not report any ACE. S/D = parental separation or divorce. MI = mental illness in the household. EA = emotional abuse. I = incarcerated household member. SA3 = sexual abuse 3 (i.e., rape). N1 = neglect 1 (i.e., no adult in household who made them feel safe and protected). N2 = neglect 2 (i.e., no adult in household who tried hard to make sure their basic needs were met). DV = domestic violence in the household.

Figure 21
History of 5 Adverse Childhood Events and Average Occasions of Binge Drinking Per Month

Note. SA2 = sexual abuse 2 (i.e., forced to sexually touch abuser). A = alcohol misuse in household. SubAddic = substance addiction in the household. PA = physical abuse. SA1 = sexual abuse 1 (i.e., molestation). None = respondent did not report any ACE. S/D = parental separation or divorce. MI = mental illness in the household. EA = emotional abuse. I = incarcerated household member. SA3 = sexual abuse 3 (i.e., rape). N1 = neglect 1 (i.e., no adult in household who made them feel safe and protected). N2 = neglect 2 (i.e., no adult in household who tried hard to make sure their basic needs were met). DV = domestic violence in the household.

Figure 22
History of 6 or More Adverse Childhood Events and Average Occasions of Binge Drinking Per Month

Note. SA2 = sexual abuse 2 (i.e., forced to sexually touch abuser). A = alcohol misuse in household. SubAddic = substance addiction in the household. PA = physical abuse. SA1 = sexual abuse 1 (i.e., molestation). None = respondent did not report any ACE. S/D = parental separation or divorce. MI = mental illness in the household. EA = emotional abuse. I = incarcerated household member. SA3 = sexual abuse 3 (i.e., rape). N1 = neglect 1 (i.e., no adult in household who made them feel safe and protected). N2 = neglect 2 (i.e., no adult in household who tried hard to make sure their basic needs were met). DV = domestic violence in the household.

Maximum number of drinks on any occasion in the past month

The fourth question refers to the largest number of drinks consumed in one occasion in the past month. This question, like the previous, is only asked to respondents that indicate they consume alcohol.

Like in the past three questions, the first equation below is the final model used to predict the maximum average number of drinks consumed on an occasion in the past month while the second equation includes the \(\beta\) estimates which are all rounded to two decimal places.

\[\begin{align*} ln(\lambda) =& \\ &\beta_0 + \\ &\beta_1 (\text{Female}) + \\ &\beta_2 (\text{18 to 24}) + \beta_3 (\text{25 to 34}) + \beta_4 (\text{35 to 44}) + \beta_5 (\text{45 to 54}) + \beta_6 (\text{55 to 64}) + \\ &\beta_7 (\text{MentalIllness}) + \beta_8 (\text{MentalIllness} \cdot \text{Female}) + \beta_9 (\text{MentalIllness} \cdot \text{18 to 24}) + \\ &\qquad \beta_{10} (\text{MentalIllness} \cdot \text{25 to 34}) + \beta_{11} (\text{MentalIllness} \cdot \text{35 to 44}) + \\ &\qquad \beta_{12} (\text{MentalIllness} \cdot \text{45 to 54}) + \beta_{13} (\text{MentalIllness} \cdot \text{55 to 64}) + \\ &\qquad \beta_{14} (\text{MentalIllness} \cdot \text{18 to 24} \cdot \text{Female}) + \beta_{15} (\text{MentalIllness} \cdot \text{25 to 34} \cdot \text{Female}) + \\ &\qquad \beta_{16} (\text{MentalIllness} \cdot \text{35 to 44} \cdot \text{Female}) + \beta_{17} (\text{MentalIllness} \cdot \text{45 to 54} \cdot \text{Female}) + \\ &\qquad \beta_{18} (\text{MentalIllness} \cdot \text{55 to 64} \cdot \text{Female}) + \\ &\beta_{19} (\text{SubstanceAddiction}) + \beta_{20} (\text{SubstanceAddiction} \cdot \text{Female}) + \beta_{21} (\text{SubstanceAddiction} \cdot \text{18 to 24}) + \\ &\qquad \beta_{22} (\text{SubstanceAddiction} \cdot \text{25 to 34}) + \beta_{23} (\text{SubstanceAddiction} \cdot \text{35 to 44}) + \\ &\qquad \beta_{24} (\text{SubstanceAddiction} \cdot \text{45 to 54}) + \beta_{25} (\text{SubstanceAddiction} \cdot \text{55 to 64}) + \\ &\qquad \beta_{26} (\text{SubstanceAddiction} \cdot \text{18 to 24} \cdot \text{Female}) + \beta_{27} (\text{SubstanceAddiction} \cdot \text{25 to 34} \cdot \text{Female}) + \\ &\qquad \beta_{28} (\text{SubstanceAddiction} \cdot \text{35 to 44} \cdot \text{Female}) + \beta_{29} (\text{SubstanceAddiction} \cdot \text{45 to 54} \cdot \text{Female}) + \\ &\qquad \beta_{30} (\text{SubstanceAddiction} \cdot \text{55 to 64} \cdot \text{Female}) + \\ &\beta_{31} (\text{Incarcerated}) + \beta_{32} (\text{Incarcerated} \cdot \text{Female}) + \beta_{33} (\text{Incarcerated} \cdot \text{18 to 24}) + \\ &\qquad \beta_{34} (\text{Incarcerated} \cdot \text{25 to 34}) + \beta_{35} (\text{Incarcerated} \cdot \text{35 to 44}) + \\ &\qquad \beta_{36} (\text{Incarcerated} \cdot \text{45 to 54}) + \beta_{37} (\text{Incarcerated} \cdot \text{55 to 64}) + \\ &\qquad \beta_{38} (\text{Incarcerated} \cdot \text{18 to 24} \cdot \text{Female}) + \beta_{39} (\text{Incarcerated} \cdot \text{25 to 34} \cdot \text{Female}) + \\ &\qquad \beta_{40} (\text{Incarcerated} \cdot \text{35 to 44} \cdot \text{Female}) + \beta_{41} (\text{Incarcerated} \cdot \text{45 to 54} \cdot \text{Female}) + \\ &\qquad \beta_{42} (\text{Incarcerated} \cdot \text{55 to 64} \cdot \text{Female}) + \\ &\beta_{43} (\text{Alcohol}) + \beta_{44} (\text{Alcohol} \cdot \text{Female}) + \beta_{45} (\text{Alcohol} \cdot \text{18 to 24}) + \\ &\qquad \beta_{46} (\text{Alcohol} \cdot \text{25 to 34}) + \beta_{47} (\text{Alcohol} \cdot \text{35 to 44}) + \\ &\qquad \beta_{48} (\text{Alcohol} \cdot \text{45 to 54}) + \beta_{49} (\text{Alcohol} \cdot \text{55 to 64}) + \\ &\qquad \beta_{50} (\text{Alcohol} \cdot \text{18 to 24} \cdot \text{Female}) + \beta_{51} (\text{Alcohol} \cdot \text{25 to 34} \cdot \text{Female}) + \\ &\qquad \beta_{52} (\text{Alcohol} \cdot \text{35 to 44} \cdot \text{Female}) + \beta_{53} (\text{Alcohol} \cdot \text{45 to 54} \cdot \text{Female}) + \\ &\qquad \beta_{54} (\text{Alcohol} \cdot \text{55 to 64} \cdot \text{Female}) + \\ &\beta_{55} (\text{SeparationDivorce}) + \beta_{56} (\text{SeparationDivorce} \cdot \text{Female}) + \beta_{57} (\text{SeparationDivorce} \cdot \text{18 to 24}) + \\ &\qquad \beta_{58} (\text{SeparationDivorce} \cdot \text{25 to 34}) + \beta_{59} (\text{SeparationDivorce} \cdot \text{35 to 44}) + \\ &\qquad \beta_{60} (\text{SeparationDivorce} \cdot \text{45 to 54}) + \beta_{61} (\text{SeparationDivorce} \cdot \text{55 to 64}) + \\ &\qquad \beta_{62} (\text{SeparationDivorce} \cdot \text{18 to 24} \cdot \text{Female}) + \beta_{63} (\text{SeparationDivorce} \cdot \text{25 to 34} \cdot \text{Female}) + \\ &\qquad \beta_{64} (\text{SeparationDivorce} \cdot \text{35 to 44} \cdot \text{Female}) + \beta_{65} (\text{SeparationDivorce} \cdot \text{45 to 54} \cdot \text{Female}) + \\ &\qquad \beta_{66} (\text{SeparationDivorce} \cdot \text{55 to 64} \cdot \text{Female}) + \\ &\beta_{67} (\text{DomesticViolence}) + \beta_{68} (\text{DomesticViolence} \cdot \text{Female}) + \beta_{69} (\text{DomesticViolence} \cdot \text{18 to 24}) + \\ &\qquad \beta_{70} (\text{DomesticViolence} \cdot \text{25 to 34}) + \beta_{71} (\text{DomesticViolence} \cdot \text{35 to 44}) + \\ &\qquad \beta_{72} (\text{DomesticViolence} \cdot \text{45 to 54}) + \beta_{73} (\text{DomesticViolence} \cdot \text{55 to 64}) + \\ &\qquad \beta_{74} (\text{DomesticViolence} \cdot \text{18 to 24} \cdot \text{Female}) + \beta_{75} (\text{DomesticViolence} \cdot \text{25 to 34} \cdot \text{Female}) + \\ &\qquad \beta_{76} (\text{DomesticViolence} \cdot \text{35 to 44} \cdot \text{Female}) + \beta_{77} (\text{DomesticViolence} \cdot \text{45 to 54} \cdot \text{Female}) + \\ &\qquad \beta_{78} (\text{DomesticViolence} \cdot \text{55 to 64} \cdot \text{Female}) + \\ &\beta_{79} (\text{PhysicalAbuse}) + \beta_{80} (\text{PhysicalAbuse} \cdot \text{Female}) + \beta_{81} (\text{PhysicalAbuse} \cdot \text{18 to 24}) + \\ &\qquad \beta_{82} (\text{PhysicalAbuse} \cdot \text{25 to 34}) + \beta_{83} (\text{PhysicalAbuse} \cdot \text{35 to 44}) + \\ &\qquad \beta_{84} (\text{PhysicalAbuse} \cdot \text{45 to 54}) + \beta_{85} (\text{PhysicalAbuse} \cdot \text{55 to 64}) + \\ &\qquad \beta_{86} (\text{PhysicalAbuse} \cdot \text{18 to 24} \cdot \text{Female}) + \beta_{87} (\text{PhysicalAbuse} \cdot \text{25 to 34} \cdot \text{Female}) + \\ &\qquad \beta_{88} (\text{PhysicalAbuse} \cdot \text{35 to 44} \cdot \text{Female}) + \beta_{89} (\text{PhysicalAbuse} \cdot \text{45 to 54} \cdot \text{Female}) + \\ &\qquad \beta_{90} (\text{PhysicalAbuse} \cdot \text{55 to 64} \cdot \text{Female}) + \\ &\beta_{91} (\text{EmotionalAbuse}) + \beta_{92} (\text{EmotionalAbuse} \cdot \text{Female}) + \beta_{93} (\text{EmotionalAbuse} \cdot \text{18 to 24}) + \\ &\qquad \beta_{94} (\text{EmotionalAbuse} \cdot \text{25 to 34}) + \beta_{95} (\text{EmotionalAbuse} \cdot \text{35 to 44}) + \\ &\qquad \beta_{96} (\text{EmotionalAbuse} \cdot \text{45 to 54}) + \beta_{97} (\text{EmotionalAbuse} \cdot \text{55 to 64}) + \\ &\qquad \beta_{98} (\text{EmotionalAbuse} \cdot \text{18 to 24} \cdot \text{Female}) + \beta_{99} (\text{EmotionalAbuse} \cdot \text{25 to 34} \cdot \text{Female}) + \\ &\qquad \beta_{100} (\text{EmotionalAbuse} \cdot \text{35 to 44} \cdot \text{Female}) + \beta_{101} (\text{EmotionalAbuse} \cdot \text{45 to 54} \cdot \text{Female}) + \\ &\qquad \beta_{102} (\text{EmotionalAbuse} \cdot \text{55 to 64} \cdot \text{Female}) + \\ &\beta_{103} (\text{SexualAbuse1}) + \beta_{104} (\text{SexualAbuse1} \cdot \text{Female}) + \beta_{105} (\text{SexualAbuse1} \cdot \text{18 to 24}) + \\ &\qquad \beta_{106} (\text{SexualAbuse1} \cdot \text{25 to 34}) + \beta_{107} (\text{SexualAbuse1} \cdot \text{35 to 44}) + \\ &\qquad \beta_{108} (\text{SexualAbuse1} \cdot \text{45 to 54}) + \beta_{109} (\text{SexualAbuse1} \cdot \text{55 to 64}) + \\ &\qquad \beta_{110} (\text{SexualAbuse1} \cdot \text{18 to 24} \cdot \text{Female}) + \beta_{111} (\text{SexualAbuse1} \cdot \text{25 to 34} \cdot \text{Female}) + \\ &\qquad \beta_{112} (\text{SexualAbuse1} \cdot \text{35 to 44} \cdot \text{Female}) + \beta_{113} (\text{SexualAbuse1} \cdot \text{45 to 54} \cdot \text{Female}) + \\ &\qquad \beta_{114} (\text{SexualAbuse1} \cdot \text{55 to 64} \cdot \text{Female}) + \\ &\beta_{115} (\text{SexualAbuse2}) + \beta_{116} (\text{SexualAbuse2} \cdot \text{Female}) + \beta_{117} (\text{SexualAbuse2} \cdot \text{18 to 24}) + \\ &\qquad \beta_{118} (\text{SexualAbuse2} \cdot \text{25 to 34}) + \beta_{119} (\text{SexualAbuse2} \cdot \text{35 to 44}) + \\ &\qquad \beta_{120} (\text{SexualAbuse2} \cdot \text{45 to 54}) + \beta_{121} (\text{SexualAbuse2} \cdot \text{55 to 64}) + \\ &\qquad \beta_{122} (\text{SexualAbuse2} \cdot \text{18 to 24} \cdot \text{Female}) + \beta_{123} (\text{SexualAbuse2} \cdot \text{25 to 34} \cdot \text{Female}) + \\ &\qquad \beta_{124} (\text{SexualAbuse2} \cdot \text{35 to 44} \cdot \text{Female}) + \beta_{125} (\text{SexualAbuse2} \cdot \text{45 to 54} \cdot \text{Female}) + \\ &\qquad \beta_{126} (\text{SexualAbuse2} \cdot \text{55 to 64} \cdot \text{Female}) + \\ &\beta_{127} (\text{SexualAbuse3}) + \beta_{128} (\text{SexualAbuse3} \cdot \text{Female}) + \beta_{129} (\text{SexualAbuse3} \cdot \text{18 to 24}) + \\ &\qquad \beta_{130} (\text{SexualAbuse3} \cdot \text{25 to 34}) + \beta_{131} (\text{SexualAbuse3} \cdot \text{35 to 44}) + \\ &\qquad \beta_{132} (\text{SexualAbuse3} \cdot \text{45 to 54}) + \beta_{133} (\text{SexualAbuse3} \cdot \text{55 to 64}) + \\ &\qquad \beta_{134} (\text{SexualAbuse3} \cdot \text{18 to 24} \cdot \text{Female}) + \beta_{135} (\text{SexualAbuse3} \cdot \text{25 to 34} \cdot \text{Female}) + \\ &\qquad \beta_{136} (\text{SexualAbuse3} \cdot \text{35 to 44} \cdot \text{Female}) + \beta_{137} (\text{SexualAbuse3} \cdot \text{45 to 54} \cdot \text{Female}) + \\ &\qquad \beta_{138} (\text{SexualAbuse3} \cdot \text{55 to 64} \cdot \text{Female}) + \\ &\beta_{139} (\text{Neglect1}) + \beta_{140} (\text{Neglect1} \cdot \text{Female}) + \beta_{141} (\text{Neglect1} \cdot \text{18 to 24}) + \\ &\qquad \beta_{142} (\text{Neglect1} \cdot \text{25 to 34}) + \beta_{143} (\text{Neglect1} \cdot \text{35 to 44}) + \\ &\qquad \beta_{144} (\text{Neglect1} \cdot \text{45 to 54}) + \beta_{145} (\text{Neglect1} \cdot \text{55 to 64}) + \\ &\qquad \beta_{146} (\text{Neglect1} \cdot \text{18 to 24} \cdot \text{Female}) + \beta_{147} (\text{Neglect1} \cdot \text{25 to 34} \cdot \text{Female}) + \\ &\qquad \beta_{148} (\text{Neglect1} \cdot \text{35 to 44} \cdot \text{Female}) + \beta_{149} (\text{Neglect1} \cdot \text{45 to 54} \cdot \text{Female}) + \\ &\qquad \beta_{150} (\text{Neglect1} \cdot \text{55 to 64} \cdot \text{Female}) + \\ &\beta_{151} (\text{Neglect2}) + \beta_{152} (\text{Neglect2} \cdot \text{Female}) + \beta_{153} (\text{Neglect2} \cdot \text{18 to 24}) + \\ &\qquad \beta_{154} (\text{Neglect2} \cdot \text{25 to 34}) + \beta_{155} (\text{Neglect2} \cdot \text{35 to 44}) + \\ &\qquad \beta_{156} (\text{Neglect2} \cdot \text{45 to 54}) + \beta_{157} (\text{Neglect2} \cdot \text{55 to 64}) + \\ &\qquad \beta_{158} (\text{Neglect2} \cdot \text{18 to 24} \cdot \text{Female}) + \beta_{159} (\text{Neglect2} \cdot \text{25 to 34} \cdot \text{Female}) + \\ &\qquad \beta_{160} (\text{Neglect2} \cdot \text{35 to 44} \cdot \text{Female}) + \beta_{161} (\text{Neglect2} \cdot \text{45 to 54} \cdot \text{Female}) + \\ &\qquad \beta_{162} (\text{Neglect2} \cdot \text{55 to 64} \cdot \text{Female}) \\ \end{align*}\] \[\begin{align*} ln(\lambda) =& \\ &3.36 + \\ &0.57 (\text{Female}) + \\ &3.21 (\text{18 to 24}) + 1.89 (\text{25 to 34}) + 1.15 (\text{35 to 44}) + 0.97 (\text{45 to 54}) + 1.30 (\text{55 to 64}) + \\ &0.93 (\text{MentalIllness}) + 1.05 (\text{MentalIllness} \cdot \text{Female}) + 1.00 (\text{MentalIllness} \cdot \text{18 to 24}) + \\ &\qquad 1.04 (\text{MentalIllness} \cdot \text{25 to 34}) + 1.00 (\text{MentalIllness} \cdot \text{35 to 44}) + \\ &\qquad 0.96 (\text{MentalIllness} \cdot \text{45 to 54}) + 1.02 (\text{MentalIllness} \cdot \text{55 to 64}) + \\ &\qquad 1.03 (\text{MentalIllness} \cdot \text{18 to 24} \cdot \text{Female}) + 0.96 (\text{MentalIllness} \cdot \text{25 to 34} \cdot \text{Female}) + \\ &\qquad 1.01 (\text{MentalIllness} \cdot \text{35 to 44} \cdot \text{Female}) + 1.10 (\text{MentalIllness} \cdot \text{45 to 54} \cdot \text{Female}) + \\ &\qquad 0.95 (\text{MentalIllness} \cdot \text{55 to 64} \cdot \text{Female}) + \\ &1.18 (\text{SubstanceAddiction}) + 0.99 (\text{SubstanceAddiction} \cdot \text{Female}) + 0.92 (\text{SubstanceAddiction} \cdot \text{18 to 24}) + \\ &\qquad 0.87 (\text{SubstanceAddiction} \cdot \text{25 to 34}) + 0.87 (\text{SubstanceAddiction} \cdot \text{35 to 44}) + \\ &\qquad 0.92 (\text{SubstanceAddiction} \cdot \text{45 to 54}) + 0.88 (\text{SubstanceAddiction} \cdot \text{55 to 64}) + \\ &\qquad 0.95 (\text{SubstanceAddiction} \cdot \text{18 to 24} \cdot \text{Female}) + 1.11 (\text{SubstanceAddiction} \cdot \text{25 to 34} \cdot \text{Female}) + \\ &\qquad 0.97 (\text{SubstanceAddiction} \cdot \text{35 to 44} \cdot \text{Female}) + 0.97 (\text{SubstanceAddiction} \cdot \text{45 to 54} \cdot \text{Female}) + \\ &\qquad 0.93 (\text{SubstanceAddiction} \cdot \text{55 to 64} \cdot \text{Female}) + \\ &1.00 (\text{Incarcerated}) + 1.06 (\text{Incarcerated} \cdot \text{Female}) + 1.01 (\text{Incarcerated} \cdot \text{18 to 24}) + \\ &\qquad 1.13 (\text{Incarcerated} \cdot \text{25 to 34}) + 1.16 (\text{Incarcerated} \cdot \text{35 to 44}) + \\ &\qquad 1.07 (\text{Incarcerated} \cdot \text{45 to 54}) + 1.02 (\text{Incarcerated} \cdot \text{55 to 64}) + \\ &\qquad 1.01 (\text{Incarcerated} \cdot \text{18 to 24} \cdot \text{Female}) + 0.90 (\text{Incarcerated} \cdot \text{25 to 34} \cdot \text{Female}) + \\ &\qquad 0.87 (\text{Incarcerated} \cdot \text{35 to 44} \cdot \text{Female}) + 0.93 (\text{Incarcerated} \cdot \text{45 to 54} \cdot \text{Female}) + \\ &\qquad 0.99 (\text{Incarcerated} \cdot \text{55 to 64} \cdot \text{Female}) + \\ &1.04 (\text{Alcohol}) + 1.04 (\text{Alcohol} \cdot \text{Female}) + 1.05 (\text{Alcohol} \cdot \text{18 to 24}) + \\ &\qquad 1.05 (\text{Alcohol} \cdot \text{25 to 34}) + 1.07 (\text{Alcohol} \cdot \text{35 to 44}) + \\ &\qquad 1.09 (\text{Alcohol} \cdot \text{45 to 54}) + 1.03 (\text{Alcohol} \cdot \text{55 to 64}) + \\ &\qquad 0.96 (\text{Alcohol} \cdot \text{18 to 24} \cdot \text{Female}) + 0.95 (\text{Alcohol} \cdot \text{25 to 34} \cdot \text{Female}) + \\ &\qquad 0.98 (\text{Alcohol} \cdot \text{35 to 44} \cdot \text{Female}) + 0.91 (\text{Alcohol} \cdot \text{45 to 54} \cdot \text{Female}) + \\ &\qquad 0.97 (\text{Alcohol} \cdot \text{55 to 64} \cdot \text{Female}) + \\ &1.11 (\text{SeparationDivorce}) + 0.94 (\text{SeparationDivorce} \cdot \text{Female}) + 0.94 (\text{SeparationDivorce} \cdot \text{18 to 24}) + \\ &\qquad 0.93 (\text{SeparationDivorce} \cdot \text{25 to 34}) + 0.89 (\text{SeparationDivorce} \cdot \text{35 to 44}) + \\ &\qquad 0.84 (\text{SeparationDivorce} \cdot \text{45 to 54}) + 0.94 (\text{SeparationDivorce} \cdot \text{55 to 64}) + \\ &\qquad 0.92 (\text{SeparationDivorce} \cdot \text{18 to 24} \cdot \text{Female}) + 1.01 (\text{SeparationDivorce} \cdot \text{25 to 34} \cdot \text{Female}) + \\ &\qquad 1.12 (\text{SeparationDivorce} \cdot \text{35 to 44} \cdot \text{Female}) + 1.13 (\text{SeparationDivorce} \cdot \text{45 to 54} \cdot \text{Female}) + \\ &\qquad 1.06 (\text{SeparationDivorce} \cdot \text{55 to 64} \cdot \text{Female}) + \\ &1.13 (\text{DomesticViolence}) + 0.89 (\text{DomesticViolence} \cdot \text{Female}) + 0.79 (\text{DomesticViolence} \cdot \text{18 to 24}) + \\ &\qquad 0.92 (\text{DomesticViolence} \cdot \text{25 to 34}) + 0.81 (\text{DomesticViolence} \cdot \text{35 to 44}) + \\ &\qquad 0.81 (\text{DomesticViolence} \cdot \text{45 to 54}) + 0.96 (\text{DomesticViolence} \cdot \text{55 to 64}) + \\ &\qquad 1.34 (\text{DomesticViolence} \cdot \text{18 to 24} \cdot \text{Female}) + 1.04 (\text{DomesticViolence} \cdot \text{25 to 34} \cdot \text{Female}) + \\ &\qquad 1.22 (\text{DomesticViolence} \cdot \text{35 to 44} \cdot \text{Female}) + 1.34 (\text{DomesticViolence} \cdot \text{45 to 54} \cdot \text{Female}) + \\ &\qquad 1.05 (\text{DomesticViolence} \cdot \text{55 to 64} \cdot \text{Female}) + \\ &1.04 (\text{PhysicalAbuse}) + 1.02 (\text{PhysicalAbuse} \cdot \text{Female}) + 1.1 (\text{PhysicalAbuse} \cdot \text{18 to 24}) + \\ &\qquad 1.00 (\text{PhysicalAbuse} \cdot \text{25 to 34}) + 0.98 (\text{PhysicalAbuse} \cdot \text{35 to 44}) + \\ &\qquad 1.05 (\text{PhysicalAbuse} \cdot \text{45 to 54}) + 1.06 (\text{PhysicalAbuse} \cdot \text{55 to 64}) + \\ &\qquad 0.86 (\text{PhysicalAbuse} \cdot \text{18 to 24} \cdot \text{Female}) + 0.93 (\text{PhysicalAbuse} \cdot \text{25 to 34} \cdot \text{Female}) + \\ &\qquad 0.98 (\text{PhysicalAbuse} \cdot \text{35 to 44} \cdot \text{Female}) + 0.94 (\text{PhysicalAbuse} \cdot \text{45 to 54} \cdot \text{Female}) + \\ &\qquad 0.95 (\text{PhysicalAbuse} \cdot \text{55 to 64} \cdot \text{Female}) + \\ &1.08 (\text{EmotionalAbuse}) + 0.98 (\text{EmotionalAbuse} \cdot \text{Female}) + 0.94 (\text{EmotionalAbuse} \cdot \text{18 to 24}) + \\ &\qquad 0.96 (\text{EmotionalAbuse} \cdot \text{25 to 34}) + 1.04 (\text{EmotionalAbuse} \cdot \text{35 to 44}) + \\ &\qquad 0.99 (\text{EmotionalAbuse} \cdot \text{45 to 54}) + 0.98 (\text{EmotionalAbuse} \cdot \text{55 to 64}) + \\ &\qquad 1.08 (\text{EmotionalAbuse} \cdot \text{18 to 24} \cdot \text{Female}) + 1.09 (\text{EmotionalAbuse} \cdot \text{25 to 34} \cdot \text{Female}) + \\ &\qquad 0.93 (\text{EmotionalAbuse} \cdot \text{35 to 44} \cdot \text{Female}) + 0.99 (\text{EmotionalAbuse} \cdot \text{45 to 54} \cdot \text{Female}) + \\ &\qquad 1.01 (\text{EmotionalAbuse} \cdot \text{55 to 64} \cdot \text{Female}) + \\ &1.01 (\text{SexualAbuse1}) + 1.00 (\text{SexualAbuse1} \cdot \text{Female}) + 1.14 (\text{SexualAbuse1} \cdot \text{18 to 24}) + \\ &\qquad 0.85 (\text{SexualAbuse1} \cdot \text{25 to 34}) + 1.29 (\text{SexualAbuse1} \cdot \text{35 to 44}) + \\ &\qquad 0.86 (\text{SexualAbuse1} \cdot \text{45 to 54}) + 0.83 (\text{SexualAbuse1} \cdot \text{55 to 64}) + \\ &\qquad 0.83 (\text{SexualAbuse1} \cdot \text{18 to 24} \cdot \text{Female}) + 1.10 (\text{SexualAbuse1} \cdot \text{25 to 34} \cdot \text{Female}) + \\ &\qquad 0.78 (\text{SexualAbuse1} \cdot \text{35 to 44} \cdot \text{Female}) + 1.11 (\text{SexualAbuse1} \cdot \text{45 to 54} \cdot \text{Female}) + \\ &\qquad 1.19 (\text{SexualAbuse1} \cdot \text{55 to 64} \cdot \text{Female}) + \\ &0.99 (\text{SexualAbuse2}) + 1.05 (\text{SexualAbuse2} \cdot \text{Female}) + 0.68 (\text{SexualAbuse2} \cdot \text{18 to 24}) + \\ &\qquad 1.24 (\text{SexualAbuse2} \cdot \text{25 to 34}) + 0.99 (\text{SexualAbuse2} \cdot \text{35 to 44}) + \\ &\qquad 1.29 (\text{SexualAbuse2} \cdot \text{45 to 54}) + 1.14 (\text{SexualAbuse2} \cdot \text{55 to 64}) + \\ &\qquad 1.49 (\text{SexualAbuse2} \cdot \text{18 to 24} \cdot \text{Female}) + 0.79 (\text{SexualAbuse2} \cdot \text{25 to 34} \cdot \text{Female}) + \\ &\qquad 0.98 (\text{SexualAbuse2} \cdot \text{35 to 44} \cdot \text{Female}) + 0.80 (\text{SexualAbuse2} \cdot \text{45 to 54} \cdot \text{Female}) + \\ &\qquad 0.86 (\text{SexualAbuse2} \cdot \text{55 to 64} \cdot \text{Female}) + \\ &1.02 (\text{SexualAbuse3}) + 1.00 (\text{SexualAbuse3} \cdot \text{Female}) + 1.27 (\text{SexualAbuse3} \cdot \text{18 to 24}) + \\ &\qquad 0.94 (\text{SexualAbuse3} \cdot \text{25 to 34}) + 1.04 (\text{SexualAbuse3} \cdot \text{35 to 44}) + \\ &\qquad 1.14 (\text{SexualAbuse3} \cdot \text{45 to 54}) + 1.17 (\text{SexualAbuse3} \cdot \text{55 to 64}) + \\ &\qquad 1.00 (\text{SexualAbuse3} \cdot \text{18 to 24} \cdot \text{Female}) + 1.03 (\text{SexualAbuse3} \cdot \text{25 to 34} \cdot \text{Female}) + \\ &\qquad 0.99 (\text{SexualAbuse3} \cdot \text{35 to 44} \cdot \text{Female}) + 0.82 (\text{SexualAbuse3} \cdot \text{45 to 54} \cdot \text{Female}) + \\ &\qquad 0.86 (\text{SexualAbuse3} \cdot \text{55 to 64} \cdot \text{Female}) + \\ &1.02 (\text{Neglect1}) + 0.96 (\text{Neglect1} \cdot \text{Female}) + 1.12 (\text{Neglect1} \cdot \text{18 to 24}) + \\ &\qquad 1.11 (\text{Neglect1} \cdot \text{25 to 34}) + 0.96 (\text{Neglect1} \cdot \text{35 to 44}) + \\ &\qquad 1.09 (\text{Neglect1} \cdot \text{45 to 54}) + 0.93 (\text{Neglect1} \cdot \text{55 to 64}) + \\ &\qquad 1.08 (\text{Neglect1} \cdot \text{18 to 24} \cdot \text{Female}) + 0.87 (\text{Neglect1} \cdot \text{25 to 34} \cdot \text{Female}) + \\ &\qquad 1.28 (\text{Neglect1} \cdot \text{35 to 44} \cdot \text{Female}) + 1.16 (\text{Neglect1} \cdot \text{45 to 54} \cdot \text{Female}) + \\ &\qquad 1.02 (\text{Neglect1} \cdot \text{55 to 64} \cdot \text{Female}) + \\ &0.74 (\text{Neglect2}) + 1.25 (\text{Neglect2} \cdot \text{Female}) + 0.65 (\text{Neglect2} \cdot \text{18 to 24}) + \\ &\qquad 0.99 (\text{Neglect2} \cdot \text{25 to 34}) + 1.72 (\text{Neglect2} \cdot \text{35 to 44}) + \\ &\qquad 1.68 (\text{Neglect2} \cdot \text{45 to 54}) + 1.15 (\text{Neglect2} \cdot \text{55 to 64}) + \\ &\qquad 1.02 (\text{Neglect2} \cdot \text{18 to 24} \cdot \text{Female}) + 1.30 (\text{Neglect2} \cdot \text{25 to 34} \cdot \text{Female}) + \\ &\qquad 0.41 (\text{Neglect2} \cdot \text{35 to 44} \cdot \text{Female}) + 0.41 (\text{Neglect2} \cdot \text{45 to 54} \cdot \text{Female}) + \\ &\qquad 1.02 (\text{Neglect2} \cdot \text{55 to 64} \cdot \text{Female}) \\ \end{align*}\]

Interpretation

Those that were males 65 and older that report no history of any ACE in the past month that the largest average number of alcoholic drinks consumed on an occasion in the past month was 3.36 (\(\beta_{0} = 3.36\), \(SE = 0.09\), \(t = 13.52\), \(p < .000001\)). Females overall did not report on average any different maximum number of drinks on an occasion in the past month compared to males 65 and older that report no history of any ACE (\(\beta_1 = 0.57\), \(SE = 0.22\), \(t = -2.50\), \(p = .012\)). Those that were female and were also between the ages of 18 to 24, or 25 to 34, or 45 to 54, or 55 to 64, were not shown to report on average any differently compared to males 65 and older that report no history of any ACE for the maximum number of drinks consumed on an occasion in the past month (see Table 6 for further information).

Those that were between the ages of 18 to 24 were shown to report on average 3.21 times more maximum number of drinks on an occasion compared to males 65 and older that report no history of any ACE (\(\beta_2 = 3.21\), \(SE = 0.16\), \(t = 7.18\), \(p < .000001\)). Those that were between the ages of 25 to 34 were shown to report on average 1.89 times more maximum number of drinks on an occasion compared to males 65 and older that report no history of any ACE (\(\beta_3 = 1.89\), \(SE = 0.13\), \(t = 4.78\), \(p < .00001\)). In addition, those that were either between the ages of 35 to 44 (\(\beta_4 = 1.15\), \(SE = 0.17\), \(t = 0.82\), \(p = .409\)), or 45 to 54 (\(\beta_5 = 0.97\), \(SE = 0.17\), \(t = -0.18\), \(p = .854\)), or 55 to 64 (\(\beta_6 = 1.30\), \(SE = 0.16\), \(t = 1.66\), \(p = .097\)) were not shown to differ in the average maximum number of alcoholic drinks consumed in the past month compared to males 65 and older that report no history of any ACE.

Those that report a history of parental separation or divorce were shown to have 1.11 times higher maximum number of drinks on an occasion compared to males 65 and older that report no history of any ACE (\(\beta_{55} = 1.11\), \(SE = 0.03\), \(t = 3.25\), \(p = .001\)). Those that reported a history of parental separation or divorce and that were also between the ages of 35 to 44 (\(\beta_{59} = 0.89\), \(SE = 0.04\), \(t = -2.86\), \(p = .004\)) or 45 to 54 (\(\beta_{60} = 0.84\), \(SE = 0.04\), \(t = -4.10\), \(p < .0001\)), respectfully, were shown to have on average 0.89 or 0.84 times fewer maximum number of drinks on an occasion in the past month compared to males 65 and older that report no history of any ACE. No other two-way or three-way interaction was shown to be different from the average maximum number of drinks on an occasion in the past month for males 65 and older that report no history of any ACE (see Table 6 for further information).

Those that report a history of domestic violence in the household are shown to report on average 1.13 times higher maximum number of drinks on an occasion compared to males 65 and older that report no history of any ACE (\(\beta_{67} = 1.13\), \(SE = .04\), \(t = 3.35\), \(p < .001\)). Those that report a history of domestic violence in the household that are either between the ages of 18 to 24 (\(\beta_{69} = 0.79\), \(SE = 0.06\), \(t = -3.79\), \(p < .001\)), or 25 to 34 (\(\beta_{70} = 0.92\), \(SE = 0.05\), \(t = -1.65\), \(p = .098\)), or 35 to 44 (\(\beta_{71} = 0.81\), \(SE = 0.05\), \(t = -4.03\), \(p < .0001\)), or 45 to 54 (\(\beta_{72} = 0.81\), \(SE = 0.05\), \(t = -4.09\), \(p < .0001\)), respectfully, were shown to report on average 0.79, or 0.92, or 0.81, or 0.81 times fewer maximum number of drinks on an occasion in the past month compared to males 65 and older that report no history of any ACE. Three-way interactions for those who are female that report a history of domestic violence in the household and are either between the ages of 18 to 24 (\(\beta_{74} = 1.34\), \(SE = 0.10\), \(t = 2.95\), \(p = .003\)), or or 45 to 54 (\(\beta_{77} = 1.34\), \(SE = 0.08\), \(t = 3.58\), \(p < .001\)), respectfully, were shown to report on average 1.34 or 1.34 times higher maximum number of drinks on an occasion in the past month compared to males 65 and older that report no history of any ACE. No other two-way or three-way interactions were shown to be different from the average maximum number of drinks on an occasion for males 65 and older that report no history of any ACE (see Table 6 for further information).

Those that report a history of substance addiction in the household are shown to have on average 1.18 times higher maximum number of drinks on an occasion compared to males 65 and older that report no history of any ACE (\(\beta_{19} = 1.18\), \(SE = 0.06\), \(t = 2.94\), \(p = .003\)), but no two-way or three-way interactions were shown to report indicate those with more specific characteristics to report different average number of maximum drinks consumed on one occasion in the past month compared to males 65 and older that report no history of any ACE (see Table 6 for further information).

Those that report a history of being sexually assaulted through molestation (SA1) that were between the ages of 35 to 44 were shown to report on average 1.29 times higher maximum number of drinks on an occasion in the past month compared to males 65 and older that report no history of any ACE (\(\beta_{107} = 1.29\), \(SE = 0.10\), \(t = 2.68\), \(p = .007\)). Those that report a history of being sexually assaulted through molestation along with any two-way and three-way interactions were not shown to report any differently from the average maximum number of drinks on an occasion for males 65 and older that report no history of any ACE (see Table 6 for further information).

Those that report a history of being forced to sexually touch an abuser (SA2) that are also between the ages of 18 to 24 were shown to report on average 0.68 times fewer maximum number of drinks on an occasion in the past month compared to males 65 and older that report no history of any ACE (\(\beta_{117} = 0.68\), \(SE = 0.14\), \(t = -2.73\), \(p = .006\)), but those between the ages of 45 to 54 were shown to report on average 1.29 times more maximum number of drinks compared to males 65 and older that report no history of any ACE (\(\beta_{120} = 1.29\), \(SE = 0.10\), \(t = 2.63\), \(p = .009\)). All other two-way and three-way interactions with this ACE were not shown to report any differently from the average maximum number of drinks on an occasion in the past month for males 65 and older that report no history of any ACE (see Table 6 for further information).

Those that report a history of emotional abuse were shown to report on average 1.08 times higher maximum number of drinks on an occasion compared to males 65 and older that report no history of any ACE (\(\beta_{91} = 1.08\), \(SE = 0.03\), \(t = 2.90\), \(p = .004\)), but no two-way or three-way interactions between a history of emotional abuse were shown to report any differently from the average maximum number of drinks on an occasion in the past month compared to males 65 and older that report no history of any ACE (see Table 6 for further information).

Those that report a history of there not being an adult in the household who tried hard to make sure their basic needs were met (i.e., Neglect2) was generally shown to report on average 0.74 times fewer drinks compared to males 65 and older that report no history of any ACE (\(\beta_{151} = 0.74\), \(SE = 0.09\), \(t = -3.23\), \(p = .001\)). Those with the same history of adversity that were between the ages of 35 to 44 were shown on average to report 1.72 times higher maximum number of drinks compared to males 65 and older that report no history of any ACE (\(\beta_{155} = 1.72\), \(SE = 0.18\), \(t = 3.06\), \(p = .002\)), but those that also report being female in along with the previously mentioned qualifications were shown to report on average 0.41 times fewer maximum number of drinks compared to males 65 and older that report no history of any ACE (\(\beta_{160} = 0.41\), \(SE = 0.32\), \(t = -2.73\), \(p = .006\)). Those with the same history of adversity that were also between the ages of 45 to 54 were shown to report on average 1.68 times greater maximum number of drinks compared to males 65 and older that report no history of any ACE (\(\beta_{156} = 1.68\), \(SE = 0.18\), \(t = 2.97\), \(p = .003\)), but those with the same history of adversity in the same age group that are specifically female were shown to report on average 0.41 times fewer maximum number of drinks compared males 65 and older that report no history of any ACE (\(\beta_{161} = 0.41\), \(SE = 0.33\), \(t = -2.66\), \(p = .008\)). For those who reported a history of there not being an adult in the household who tried hard to make sure their basic needs were met (i.e., Neglect2), there were no other two-way or three-way interactions that were shown to report any differently from the average maximum number of drinks on an occasion in the past month for males 65 and older that report no history of any ACE (see Table 4 for further information).

There were no one-way or two-way interactions between females and any of the 6 ACEs that indicated increased or decreased risk for the average maximum number of drinks on an occasion in the past month for males 65 and older that report no history of any ACE (see Table 6 for further information). In addition, all other interactions between ACEs and age categories were shown not to differ in relative risk for average maximum number of drinks on an occasion for males 65 and older that report no history of any ACE (see Table 6).

Table 6
Estimates for ACE Terms and Interactions

Table
term estimate std.error statistic p.value
sexFemale:age55 to 64 1.00 0.34 0.00 0.9978724
sexFemale:age45 to 54 1.70 0.32 1.68 0.0932733
sexFemale:age35 to 44 1.62 0.31 1.54 0.1245799
sexFemale:age25 to 34 0.76 0.33 -0.82 0.4126529
sexFemale:age18 to 24 0.82 0.43 -0.47 0.6399352
MentalIllness1 0.93 0.04 -1.70 0.0895304
MentalIllness1:sexFemale 1.05 0.06 0.81 0.4205812
MentalIllness1:age55 to 64 1.02 0.06 0.29 0.7755034
MentalIllness1:age45 to 54 0.96 0.05 -0.82 0.4104345
MentalIllness1:age35 to 44 1.00 0.05 -0.03 0.9788279
MentalIllness1:age25 to 34 1.04 0.05 0.68 0.4948591
MentalIllness1:age18 to 24 1.00 0.06 0.01 0.9889182
MentalIllness1:sexFemale:age55 to 64 0.95 0.08 -0.66 0.5107672
MentalIllness1:sexFemale:age45 to 54 1.10 0.08 1.18 0.2369220
MentalIllness1:sexFemale:age35 to 44 1.01 0.07 0.07 0.9458714
MentalIllness1:sexFemale:age25 to 34 0.96 0.08 -0.58 0.5647693
MentalIllness1:sexFemale:age18 to 24 1.03 0.09 0.35 0.7286623
Alcoholic1 1.04 0.03 1.47 0.1416249
sexFemale:Alcoholic1 1.04 0.04 1.00 0.3180040
age55 to 64:Alcoholic1 1.03 0.04 0.75 0.4529341
age45 to 54:Alcoholic1 1.09 0.04 1.97 0.0489290
age35 to 44:Alcoholic1 1.07 0.04 1.50 0.1349087
age25 to 34:Alcoholic1 1.05 0.04 1.07 0.2852107
age18 to 24:Alcoholic1 1.05 0.05 0.98 0.3258927
sexFemale:age55 to 64:Alcoholic1 0.97 0.07 -0.48 0.6325974
sexFemale:age45 to 54:Alcoholic1 0.91 0.07 -1.39 0.1649066
sexFemale:age35 to 44:Alcoholic1 0.98 0.07 -0.30 0.7642402
sexFemale:age25 to 34:Alcoholic1 0.95 0.07 -0.75 0.4550086
sexFemale:age18 to 24:Alcoholic1 0.96 0.08 -0.45 0.6554987
SubstanceAddiction1 1.18 0.06 2.94 0.0032503
sexFemale:SubstanceAddiction1 0.99 0.09 -0.09 0.9252648
age55 to 64:SubstanceAddiction1 0.88 0.07 -1.75 0.0794535
age45 to 54:SubstanceAddiction1 0.92 0.07 -1.18 0.2365184
age35 to 44:SubstanceAddiction1 0.87 0.07 -1.97 0.0490442
age25 to 34:SubstanceAddiction1 0.87 0.07 -2.10 0.0358948
age18 to 24:SubstanceAddiction1 0.92 0.08 -1.14 0.2554338
sexFemale:age55 to 64:SubstanceAddiction1 0.93 0.11 -0.64 0.5234548
sexFemale:age45 to 54:SubstanceAddiction1 0.97 0.11 -0.26 0.7960333
sexFemale:age35 to 44:SubstanceAddiction1 0.97 0.11 -0.32 0.7467481
sexFemale:age25 to 34:SubstanceAddiction1 1.11 0.11 0.96 0.3373974
sexFemale:age18 to 24:SubstanceAddiction1 0.95 0.12 -0.45 0.6493868
Incarcerated1 1.00 0.07 0.07 0.9468318
sexFemale:Incarcerated1 1.06 0.11 0.53 0.5949444
age55 to 64:Incarcerated1 1.02 0.09 0.26 0.7978054
age45 to 54:Incarcerated1 1.07 0.09 0.83 0.4060118
age35 to 44:Incarcerated1 1.16 0.08 1.82 0.0692882
age25 to 34:Incarcerated1 1.13 0.08 1.53 0.1262935
age18 to 24:Incarcerated1 1.01 0.09 0.11 0.9127886
sexFemale:age55 to 64:Incarcerated1 0.99 0.14 -0.07 0.9417392
sexFemale:age45 to 54:Incarcerated1 0.93 0.14 -0.50 0.6204720
sexFemale:age35 to 44:Incarcerated1 0.87 0.13 -1.07 0.2862079
sexFemale:age25 to 34:Incarcerated1 0.90 0.13 -0.84 0.4007729
sexFemale:age18 to 24:Incarcerated1 1.01 0.14 0.10 0.9168753
SeparationDivorce1 1.11 0.03 3.25 0.0011502
sexFemale:SeparationDivorce1 0.94 0.05 -1.21 0.2254130
age55 to 64:SeparationDivorce1 0.94 0.04 -1.30 0.1944474
age45 to 54:SeparationDivorce1 0.84 0.04 -4.10 0.0000409
age35 to 44:SeparationDivorce1 0.89 0.04 -2.86 0.0042371
age25 to 34:SeparationDivorce1 0.93 0.04 -1.63 0.1033691
age18 to 24:SeparationDivorce1 0.94 0.05 -1.23 0.2172087
sexFemale:age55 to 64:SeparationDivorce1 1.06 0.07 0.81 0.4206559
sexFemale:age45 to 54:SeparationDivorce1 1.13 0.07 1.80 0.0711622
sexFemale:age35 to 44:SeparationDivorce1 1.12 0.07 1.68 0.0939065
sexFemale:age25 to 34:SeparationDivorce1 1.01 0.07 0.16 0.8707158
sexFemale:age18 to 24:SeparationDivorce1 0.92 0.08 -1.05 0.2942366
DomesticViolence1 1.13 0.04 3.35 0.0008038
sexFemale:DomesticViolence1 0.89 0.06 -1.95 0.0515965
age55 to 64:DomesticViolence1 0.96 0.05 -0.89 0.3752250
age45 to 54:DomesticViolence1 0.81 0.05 -4.09 0.0000435
age35 to 44:DomesticViolence1 0.81 0.05 -4.03 0.0000559
age25 to 34:DomesticViolence1 0.92 0.05 -1.65 0.0980734
age18 to 24:DomesticViolence1 0.79 0.06 -3.79 0.0001497
sexFemale:age55 to 64:DomesticViolence1 1.05 0.08 0.60 0.5492840
sexFemale:age45 to 54:DomesticViolence1 1.34 0.08 3.58 0.0003385
sexFemale:age35 to 44:DomesticViolence1 1.22 0.08 2.36 0.0182934
sexFemale:age25 to 34:DomesticViolence1 1.04 0.09 0.51 0.6116338
sexFemale:age18 to 24:DomesticViolence1 1.34 0.10 2.95 0.0032229
PhysicalAbuse1 1.04 0.03 1.37 0.1711833
sexFemale:PhysicalAbuse1 1.02 0.04 0.34 0.7340060
age55 to 64:PhysicalAbuse1 1.06 0.04 1.41 0.1572601
age45 to 54:PhysicalAbuse1 1.05 0.04 1.17 0.2419369
age35 to 44:PhysicalAbuse1 0.98 0.04 -0.38 0.7076323
age25 to 34:PhysicalAbuse1 1.00 0.04 0.08 0.9351350
age18 to 24:PhysicalAbuse1 1.10 0.05 1.83 0.0679740
sexFemale:age55 to 64:PhysicalAbuse1 0.95 0.07 -0.82 0.4149613
sexFemale:age45 to 54:PhysicalAbuse1 0.94 0.07 -0.90 0.3674320
sexFemale:age35 to 44:PhysicalAbuse1 0.98 0.07 -0.29 0.7736089
sexFemale:age25 to 34:PhysicalAbuse1 0.93 0.07 -1.00 0.3169255
sexFemale:age18 to 24:PhysicalAbuse1 0.86 0.09 -1.79 0.0733975
EmotionalAbuse1 1.08 0.03 2.90 0.0037588
sexFemale:EmotionalAbuse1 0.98 0.04 -0.38 0.7033125
age55 to 64:EmotionalAbuse1 0.98 0.04 -0.66 0.5069506
age45 to 54:EmotionalAbuse1 0.99 0.04 -0.34 0.7350196
age35 to 44:EmotionalAbuse1 1.04 0.04 1.09 0.2736262
age25 to 34:EmotionalAbuse1 0.96 0.04 -1.19 0.2338567
age18 to 24:EmotionalAbuse1 0.94 0.05 -1.31 0.1903047
sexFemale:age55 to 64:EmotionalAbuse1 1.01 0.06 0.18 0.8571957
sexFemale:age45 to 54:EmotionalAbuse1 0.99 0.06 -0.14 0.8910653
sexFemale:age35 to 44:EmotionalAbuse1 0.93 0.06 -1.18 0.2373401
sexFemale:age25 to 34:EmotionalAbuse1 1.09 0.07 1.38 0.1674514
sexFemale:age18 to 24:EmotionalAbuse1 1.08 0.08 0.99 0.3230637
SexualAbuse11 1.01 0.06 0.18 0.8548163
sexFemale:SexualAbuse11 1.00 0.08 0.00 0.9990783
age55 to 64:SexualAbuse11 0.83 0.09 -1.92 0.0550022
age45 to 54:SexualAbuse11 0.86 0.09 -1.63 0.1029936
age35 to 44:SexualAbuse11 1.29 0.10 2.68 0.0074045
age25 to 34:SexualAbuse11 0.85 0.10 -1.57 0.1159743
age18 to 24:SexualAbuse11 1.14 0.12 1.07 0.2832243
sexFemale:age55 to 64:SexualAbuse11 1.19 0.12 1.45 0.1484436
sexFemale:age45 to 54:SexualAbuse11 1.11 0.12 0.86 0.3921159
sexFemale:age35 to 44:SexualAbuse11 0.78 0.12 -2.03 0.0423031
sexFemale:age25 to 34:SexualAbuse11 1.10 0.13 0.72 0.4712334
sexFemale:age18 to 24:SexualAbuse11 0.83 0.16 -1.20 0.2301295
SexualAbuse21 0.99 0.07 -0.09 0.9313650
sexFemale:SexualAbuse21 1.05 0.09 0.52 0.6050988
age55 to 64:SexualAbuse21 1.14 0.10 1.27 0.2044001
age45 to 54:SexualAbuse21 1.29 0.10 2.63 0.0086187
age35 to 44:SexualAbuse21 0.99 0.10 -0.05 0.9592954
age25 to 34:SexualAbuse21 1.24 0.11 2.03 0.0422815
age18 to 24:SexualAbuse21 0.68 0.14 -2.73 0.0062533
sexFemale:age55 to 64:SexualAbuse21 0.86 0.14 -1.08 0.2794616
sexFemale:age45 to 54:SexualAbuse21 0.80 0.13 -1.65 0.0980171
sexFemale:age35 to 44:SexualAbuse21 0.98 0.14 -0.16 0.8742385
sexFemale:age25 to 34:SexualAbuse21 0.79 0.15 -1.64 0.1003980
sexFemale:age18 to 24:SexualAbuse21 1.49 0.19 2.16 0.0311168
SexualAbuse31 1.02 0.10 0.17 0.8684110
sexFemale:SexualAbuse31 1.00 0.13 0.00 0.9987785
age55 to 64:SexualAbuse31 1.17 0.13 1.14 0.2540645
age45 to 54:SexualAbuse31 1.14 0.13 0.99 0.3206805
age35 to 44:SexualAbuse31 1.04 0.13 0.30 0.7663372
age25 to 34:SexualAbuse31 0.94 0.13 -0.47 0.6376910
age18 to 24:SexualAbuse31 1.27 0.15 1.58 0.1133261
sexFemale:age55 to 64:SexualAbuse31 0.86 0.17 -0.91 0.3630987
sexFemale:age45 to 54:SexualAbuse31 0.82 0.17 -1.14 0.2527902
sexFemale:age35 to 44:SexualAbuse31 0.99 0.17 -0.09 0.9290206
sexFemale:age25 to 34:SexualAbuse31 1.03 0.17 0.15 0.8846903
sexFemale:age18 to 24:SexualAbuse31 1.00 0.19 -0.02 0.9833425
Neglect11 1.02 0.06 0.24 0.8125889
sexFemale:Neglect11 0.96 0.12 -0.33 0.7384493
age55 to 64:Neglect11 0.93 0.12 -0.67 0.5005509
age45 to 54:Neglect11 1.09 0.11 0.82 0.4118731
age35 to 44:Neglect11 0.96 0.11 -0.38 0.7012753
age25 to 34:Neglect11 1.11 0.11 0.90 0.3694271
age18 to 24:Neglect11 1.12 0.13 0.91 0.3649580
sexFemale:age55 to 64:Neglect11 1.02 0.19 0.12 0.9076092
sexFemale:age45 to 54:Neglect11 1.16 0.19 0.77 0.4415352
sexFemale:age35 to 44:Neglect11 1.28 0.18 1.38 0.1664224
sexFemale:age25 to 34:Neglect11 0.87 0.20 -0.68 0.4988679
sexFemale:age18 to 24:Neglect11 1.08 0.24 0.33 0.7401753
Neglect21 0.74 0.09 -3.23 0.0012323
sexFemale:Neglect21 1.25 0.23 0.99 0.3243790
age55 to 64:Neglect21 1.15 0.17 0.84 0.3985701
age45 to 54:Neglect21 1.68 0.18 2.97 0.0030110
age35 to 44:Neglect21 1.72 0.18 3.06 0.0022312
age25 to 34:Neglect21 0.99 0.14 -0.05 0.9580782
age18 to 24:Neglect21 0.65 0.16 -2.59 0.0095045
sexFemale:age55 to 64:Neglect21 0.92 0.35 -0.24 0.8116582
sexFemale:age45 to 54:Neglect21 0.41 0.33 -2.66 0.0079099
sexFemale:age35 to 44:Neglect21 0.41 0.32 -2.73 0.0062527
sexFemale:age25 to 34:Neglect21 1.30 0.34 0.78 0.4358533
sexFemale:age18 to 24:Neglect21 1.02 0.44 0.04 0.9676606

     

Discussion

Figure 23 shows that those with a history of substance addiction in the household in addition to other ACEs tend to have a higher maximum number of alcoholic drinks compared to those that report no history of any ACE or that report substance addiction and fewer additional ACE that were also experienced. Overall, those that experience more ACEs that also have a history of substance addiction in the household were shown to report a greater average number of maximum alcoholic beverages.

Figure 24 (those with a history of parental separation or divorce), 25 (those with a history of domestic violence in the household), 26 (those with a history of molestation), and 27 (those with a history of forced sexual touch to abuser), show the same pattern as previously described for Figure 23 where this specific adversity combined with others shows those that experience a greater number of adversities also tend to report a greater average number of alcoholic beverages consumed on an occasion in the past month. In contrast, Figure 28 (those that reported a history of emotional abuse) or 29 (those that report a history of there not being an adult in the household who tried hard to make sure their basic needs were met) show a much less clear pattern of a greater number of ACEs experienced, including the one specified in the specific graph, as being an indicative factor for reporting a greater average number of maximum alcoholic beverages consumed on an occasion in the past month.

Figure 30 shows a high amount of variability considering the variables are grouped by gender, age group, and exactly the same history of adversity both within groups and across when grouped by adversity. Generally for Figures 30 through 35, those that are females tend to report lower average maximum alcoholic drinks consumed on an occasion in the past month compared to males. We also see those who are the youngest appear to drink the highest average maximum alcoholic drinks consumed on an occasion in the past month compared to other ages groups which is also shown to have higher variability.

Figure 23
Substance Addiction and Average Maximum Drink (last month)

Note. SA2 = sexual abuse 2 (i.e., forced to sexually touch abuser). A = alcohol misuse in household. SubAddic = substance addiction in the household. PA = physical abuse. SA1 = sexual abuse 1 (i.e., molestation). None = respondent did not report any ACE. S/D = parental separation or divorce. MI = mental illness in the household. EA = emotional abuse. I = incarcerated household member. SA3 = sexual abuse 3 (i.e., rape). N1 = neglect 1 (i.e., no adult in household who made them feel safe and protected). N2 = neglect 2 (i.e., no adult in household who tried hard to make sure their basic needs were met). DV = domestic violence in the household.

Figure 24
Parental Separation or Divorce and Average Maximum Drink (last month)

Note. SA2 = sexual abuse 2 (i.e., forced to sexually touch abuser). A = alcohol misuse in household. SubAddic = substance addiction in the household. PA = physical abuse. SA1 = sexual abuse 1 (i.e., molestation). None = respondent did not report any ACE. S/D = parental separation or divorce. MI = mental illness in the household. EA = emotional abuse. I = incarcerated household member. SA3 = sexual abuse 3 (i.e., rape). N1 = neglect 1 (i.e., no adult in household who made them feel safe and protected). N2 = neglect 2 (i.e., no adult in household who tried hard to make sure their basic needs were met). DV = domestic violence in the household.

Figure 25
Domestic Violence in Household and Average Maximum Drink (last month)

Note. SA2 = sexual abuse 2 (i.e., forced to sexually touch abuser). A = alcohol misuse in household. SubAddic = substance addiction in the household. PA = physical abuse. SA1 = sexual abuse 1 (i.e., molestation). None = respondent did not report any ACE. S/D = parental separation or divorce. MI = mental illness in the household. EA = emotional abuse. I = incarcerated household member. SA3 = sexual abuse 3 (i.e., rape). N1 = neglect 1 (i.e., no adult in household who made them feel safe and protected). N2 = neglect 2 (i.e., no adult in household who tried hard to make sure their basic needs were met). DV = domestic violence in the household.

Figure 26
Sexual Abuse (SA1) and Average Maximum Drink (last month)

Note. SA2 = sexual abuse 2 (i.e., forced to sexually touch abuser). A = alcohol misuse in household. SubAddic = substance addiction in the household. PA = physical abuse. SA1 = sexual abuse 1 (i.e., molestation). None = respondent did not report any ACE. S/D = parental separation or divorce. MI = mental illness in the household. EA = emotional abuse. I = incarcerated household member. SA3 = sexual abuse 3 (i.e., rape). N1 = neglect 1 (i.e., no adult in household who made them feel safe and protected). N2 = neglect 2 (i.e., no adult in household who tried hard to make sure their basic needs were met). DV = domestic violence in the household.

Figure 27
Sexual Abuse (SA2) and Average Maximum Drink (last month)

Note. SA2 = sexual abuse 2 (i.e., forced to sexually touch abuser). A = alcohol misuse in household. SubAddic = substance addiction in the household. PA = physical abuse. SA1 = sexual abuse 1 (i.e., molestation). None = respondent did not report any ACE. S/D = parental separation or divorce. MI = mental illness in the household. EA = emotional abuse. I = incarcerated household member. SA3 = sexual abuse 3 (i.e., rape). N1 = neglect 1 (i.e., no adult in household who made them feel safe and protected). N2 = neglect 2 (i.e., no adult in household who tried hard to make sure their basic needs were met). DV = domestic violence in the household.

Figure 28
Emotional Abuse and Average Maximum Drink (last month)

Note. SA2 = sexual abuse 2 (i.e., forced to sexually touch abuser). A = alcohol misuse in household. SubAddic = substance addiction in the household. PA = physical abuse. SA1 = sexual abuse 1 (i.e., molestation). None = respondent did not report any ACE. S/D = parental separation or divorce. MI = mental illness in the household. EA = emotional abuse. I = incarcerated household member. SA3 = sexual abuse 3 (i.e., rape). N1 = neglect 1 (i.e., no adult in household who made them feel safe and protected). N2 = neglect 2 (i.e., no adult in household who tried hard to make sure their basic needs were met). DV = domestic violence in the household.

Figure 29
Neglect (N2) and Average Maximum Drink (last month)

Note. SA2 = sexual abuse 2 (i.e., forced to sexually touch abuser). A = alcohol misuse in household. SubAddic = substance addiction in the household. PA = physical abuse. SA1 = sexual abuse 1 (i.e., molestation). None = respondent did not report any ACE. S/D = parental separation or divorce. MI = mental illness in the household. EA = emotional abuse. I = incarcerated household member. SA3 = sexual abuse 3 (i.e., rape). N1 = neglect 1 (i.e., no adult in household who made them feel safe and protected). N2 = neglect 2 (i.e., no adult in household who tried hard to make sure their basic needs were met). DV = domestic violence in the household.

Figure 30
History of 1 Adverse Childhood Event and Average Maximum Drinks (last month)

Note. SA2 = sexual abuse 2 (i.e., forced to sexually touch abuser). A = alcohol misuse in household. SubAddic = substance addiction in the household. PA = physical abuse. SA1 = sexual abuse 1 (i.e., molestation). None = respondent did not report any ACE. S/D = parental separation or divorce. MI = mental illness in the household. EA = emotional abuse. I = incarcerated household member. SA3 = sexual abuse 3 (i.e., rape). N1 = neglect 1 (i.e., no adult in household who made them feel safe and protected). N2 = neglect 2 (i.e., no adult in household who tried hard to make sure their basic needs were met). DV = domestic violence in the household.

Figure 31
History of 2 Adverse Childhood Events and Average Maximum Drinks (last month)

Note. SA2 = sexual abuse 2 (i.e., forced to sexually touch abuser). A = alcohol misuse in household. SubAddic = substance addiction in the household. PA = physical abuse. SA1 = sexual abuse 1 (i.e., molestation). None = respondent did not report any ACE. S/D = parental separation or divorce. MI = mental illness in the household. EA = emotional abuse. I = incarcerated household member. SA3 = sexual abuse 3 (i.e., rape). N1 = neglect 1 (i.e., no adult in household who made them feel safe and protected). N2 = neglect 2 (i.e., no adult in household who tried hard to make sure their basic needs were met). DV = domestic violence in the household.

Figure 32
History of 3 Adverse Childhood Events and Average Maximum Drinks (last month)

Note. SA2 = sexual abuse 2 (i.e., forced to sexually touch abuser). A = alcohol misuse in household. SubAddic = substance addiction in the household. PA = physical abuse. SA1 = sexual abuse 1 (i.e., molestation). None = respondent did not report any ACE. S/D = parental separation or divorce. MI = mental illness in the household. EA = emotional abuse. I = incarcerated household member. SA3 = sexual abuse 3 (i.e., rape). N1 = neglect 1 (i.e., no adult in household who made them feel safe and protected). N2 = neglect 2 (i.e., no adult in household who tried hard to make sure their basic needs were met). DV = domestic violence in the household.

Figure 33
History of 4 Adverse Childhood Events and Average Maximum Drinks (last month)

Note. SA2 = sexual abuse 2 (i.e., forced to sexually touch abuser). A = alcohol misuse in household. SubAddic = substance addiction in the household. PA = physical abuse. SA1 = sexual abuse 1 (i.e., molestation). None = respondent did not report any ACE. S/D = parental separation or divorce. MI = mental illness in the household. EA = emotional abuse. I = incarcerated household member. SA3 = sexual abuse 3 (i.e., rape). N1 = neglect 1 (i.e., no adult in household who made them feel safe and protected). N2 = neglect 2 (i.e., no adult in household who tried hard to make sure their basic needs were met). DV = domestic violence in the household.

Figure 34
History of 5 Adverse Childhood Events and Average Maximum Drinks (last month)

Note. SA2 = sexual abuse 2 (i.e., forced to sexually touch abuser). A = alcohol misuse in household. SubAddic = substance addiction in the household. PA = physical abuse. SA1 = sexual abuse 1 (i.e., molestation). None = respondent did not report any ACE. S/D = parental separation or divorce. MI = mental illness in the household. EA = emotional abuse. I = incarcerated household member. SA3 = sexual abuse 3 (i.e., rape). N1 = neglect 1 (i.e., no adult in household who made them feel safe and protected). N2 = neglect 2 (i.e., no adult in household who tried hard to make sure their basic needs were met). DV = domestic violence in the household.

Figure 35
History of 6 or more Adverse Childhood Events and Average Maximum Drinks (last month)

Note. SA2 = sexual abuse 2 (i.e., forced to sexually touch abuser). A = alcohol misuse in household. SubAddic = substance addiction in the household. PA = physical abuse. SA1 = sexual abuse 1 (i.e., molestation). None = respondent did not report any ACE. S/D = parental separation or divorce. MI = mental illness in the household. EA = emotional abuse. I = incarcerated household member. SA3 = sexual abuse 3 (i.e., rape). N1 = neglect 1 (i.e., no adult in household who made them feel safe and protected). N2 = neglect 2 (i.e., no adult in household who tried hard to make sure their basic needs were met). DV = domestic violence in the household.

     

Conclusion

The research presented demonstrates that the type of adversity matters when discussing risk for excessive alcohol consumption. In addition, when grouping adversities by the number reported, there is a clear distinction between ACE groupings indicating that grouping by number experienced is not an accurate way to determine those most at risk for excessive alcohol consumption. There was also some evidence that those with a history of specific ACEs are shown to engage in less overall alcohol consumption which has not previously been reported in the literature.

Future research investigating ACEs should focus on the type of adversities and interaction between adversities rather than adding the number of ACEs experienced together and using that as the dependent variable of interest. As shown, a lot of information is lost when this is done because long-term effects from parental separation or divorce are not comparable to those who had a household member with a substance addiction.

My future direction is determining the conditional probability of experiencing another ACEs based on already experiencing a certain ACE. This type of research would be extremely value to be able to allocate funding to those who most need it with limited information (race, jurisdiction, income, urban/rural, etc.,). I also plan on extending this project in the future in incorporate other addiction-like behaviors like smoking which I ran out of time to investigate here.

The data used and conclusions made here are based on self-reported data with a large potential to be skewed because ACEs is a sensitive topic, especially to those who have a history of adversity, where individuals are less likely to report them with a stranger. This is the only survey in the United States that collects information on ACEs yearly which is why it was used in this analysis. The resulted presented here are indicated as increased, decreased, or no difference in risk from the intercept group, but there is a potential that there are confounding variables because we are only accounting for this aspect of the respondents life history which is not the only variable that could effect long-term risk for excessive alcohol consumption. Visualizations try to evaluate a plethora of variables at one time which has the potential to be confusing/difficult for people to grasp what is being shown. It is also impossible with the current data to determine if age is impacting alcohol consumption as a measure of time passing or if generations are experiencing different effects.

References

Dube, S. R., Felitti, V. J., Dong, M., Chapman, D. P., Giles, W. H., & Anda, R. F. (2003). Childhood abuse, neglect, and household dysfunction and the risk of illicit drug use:The adverse childhood experiences study. Pediatrics, 111(3), 564–572. https://doi.org/10.1542/peds.111.3.564

Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., Koss, M. P., & Marks, J. S. (2019). Reprint of: Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The adverse childhood experiences (ACE) study. American Journal of Preventive Medicine, 56(6), 774–786. https://doi.org/10.1016/j.amepre.2019.04.001

Gomez, B., Peh, C. X., Cheok, C., & Guo, S. (2018). Adverse childhood experiences and illicit drug use in adolescents: Findings from a national addictions treatment population in Singapore. Journal of Substance Use, 23(1), 86–91. https://doi.org/10.1080/14659891.2017.1348558

Guarino, H., Mateu-Gelabert, P., Quinn, K., Sirikantraporn, S., Ruggles, K. V., Syckes, C., Goodbody, E., Jessell, L., & Friedman, S. R. (2021). Adverse childhood experiences predict early initiation of opioid use behaviors. Frontiers in Sociology, 6, 620395. https://doi.org/10.3389/fsoc.2021.620395

Kim, S. T., Hwang, S. S., Kim, H. W., Hwang, E. H., Cho, J., Kang, J. I., & Kim, S. J. (2018). Multidimensional impulsivity as a mediator of early life stress and alcohol dependence. Scientific Reports, 8(1), 4104. https://doi.org/10.1038/s41598-018-22474-8

Loudermilk, E., Loudermilk, K., Obenauer, J., & Quinn, M. A. (2018). Impact of adverse childhood experiences (ACEs) on adult alcohol consumption behaviors. Child Abuse & Neglect, 86, 368–374. https://doi.org/10.1016/j.chiabu.2018.08.006

Merrick, M. T., Ford, D. C., Ports, K. A., & Guinn, A. S. (2018). Prevalence of Adverse Childhood Experiences From the 2011-2014 Behavioral Risk Factor Surveillance System in 23 States. JAMA Pediatrics, 172(11), 1038. https://doi.org/10.1001/jamapediatrics.2018.2537

Pilowsky, D. J., Keyes, K. M., & Hasin, D. S. (2009). Adverse childhood events and lifetime alcohol dependence. American Journal of Public Health, 99(2), 258–263. https://doi.org/10.2105/AJPH.2008.139006

Sharma, A., & Sacco, P. (2015). Adverse Childhood Experiences and Gambling: Results From a National Survey. Journal of Social Work Practice in the Addictions, 15(1), 25–43. https://doi.org/10.1080/1533256X.2015.996502

Shin, S. H., McDonald, S. E., & Conley, D. (2018). Profiles of adverse childhood experiences and impulsivity. Child Abuse & Neglect, 85, 118–126. https://doi.org/10.1016/j.chiabu.2018.07.028

Stein, M. D., Conti, M. T., Kenney, S., Anderson, B. J., Flori, J. N., Risi, M. M., & Bailey, G. L. (2017). Adverse childhood experience effects on opioid use initiation, injection drug use, and overdose among persons with opioid use disorder. Drug and Alcohol Dependence, 179, 325–329. https://doi.org/10.1016/j.drugalcdep.2017.07.007

Strine, T. (2012). Associations between adverse childhood experiences, psychological distress, and adult alcohol problems. American Journal of Health Behavior, 36(3). https://doi.org/10.5993/AJHB.36.3.11